Successful Ovarian Vitrification and Back-Transplantation to Preserve Fertility in a Patient Requiring Chemotherapy for Malignant Lymphoma
- *Corresponding Author:
- Iwaho Kikuchi
Department of Obstetrics and Gynecology
Juntendo University School of Medicine
Hongo 2-1-1, Bunkyo-ku
Tokyo 113-8421, Japan
E-mail: [email protected]
Received Date: December 03, 2013; Accepted Date: January 02, 2014; Published Date: January 05, 2014
Citation: Kikuchi I, Kagawa N, Silber S, Isobe Y, Kuwayama M, et al. (2014) Successful Ovarian Vitrification and Back-Transplantation to Preserve Fertility in a Patient Requiring Chemotherapy for Malignant Lymphoma. J Blood Lymph 4:116. doi: 10.4172/2165-7831.1000116
Copyright: © 2014 Kikuchi I, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
For women with hematologic malignancy anticipating chemotherapy or radio therapy but wishing to preserve fertility, it is preferable that recovery from oophorectomy be as rapid as possible. Considering Reduced-Port Surgery (RPS) to be potentially suitable for such patients, we used RPS for a patient with malignant lymphoma scheduled for pre-bone marrow transplantation chemotherapy. The patient was a 28-year-old woman, gravida 0, who had requested fertility preservation. Thus, with ethics committee approval, the left ovary was removed by RPS, and ovarian cortex with primordial ovarian follicles was cryopreserved by vitrification. The cortex was divided into 12 pieces, 1 cm×1 cm×1 mm each, placed in a container, and stored in liquid nitrogen. The patient’s post-bone marrow transplantation course was good. Because she was judged to have lost ovarian function, ovarian back-transplantation was performed by RPS. The cortex of the remaining right ovary was removed with a laparoscopic cold knife and scissors while heparin saline was instilled to maintain blood flow and a 2 cm×1 cm base was created. Two thawed ovarian cortex pieces were laparoscopically sewed to the base with 5-0 absorbable sutures. By postoperative day 173, the ovarian follicle had increased to 10 mm in diameter, and the patient’s estradiol level had risen to 101 pg/ml, suggesting recovery of ovarian function. Our experience in this lymphoma case suggests that ovarian cryopreservation and back-transplantation for fertility preservation can be performed safely by RPS and is a viable option for selected patients anticipating chemotherapy and bone marrow transplantation for hematologic malignancy.