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Difficulties improving ovarian functional recovery by microvascular transplantation and whole ovary vitrification
Blandine Courbiere1, Ludovic Caquant, Claire Mazoyer
1Unité INSERM 846, Institut Cellule Souche et Cerveau, Bron, France.
Objective:
To evaluate recovery of endocrine function and fertility after transplantation and vitrification of whole ovaries.
Design:
Animal study.
Setting:
Lyon Veterinary School, France.
Animal(S):
Ewes.
Intervention(S):
In group 1 (n = 5), the left ovary was removed with its vascular pedicle and was transplanted onto the contralateral pedicle. In group 2 (n = 5), the left ovary with its pedicle was cryopreserved after a vitrification procedure. After thawing, transplantation was performed by microvascular anastomosis to the contralateral ovarian pedicle.
Main Outcome Measure(S):
Median ischemia time, progesterone levels, histologic examination.
Result(S):
Successful microsurgical transplantation was performed in both groups. The median ischemia time was statistically significantly longer in group 2 (287 minutes, range: 226 to 349] versus 129 minutes [range: 125 to 130]) in group 1. In group 1, four sheep recovered spontaneous ovarian endocrine function about 2.5 (range: 2.00 to 3.75) months after transplantation. Two ewes gave healthy live births at 12 and 25 months, respectively, after transplantation. In group 2, one ewe recovered ovarian endocrine function 6 months after transplantation. However, histologic evaluation showed a follicular survival rate of 6% in group 1, and total follicle loss in group 2.
Conclusion(S):
Autograft of whole sheep ovaries with microvascular anastomosis seems technically feasible but resulted in a very poor follicle survival rate (6%), in spite of endocrine function recovery and birth of two lambs. Attempts at cryopreservation with vitrification resulted in no follicle survival at all.
