Creating a Global Community of Practice for Oncofertility.

Fertility preservation in the cancer setting, known as oncofertility, is a field that requires cross-disciplinary interaction between physicians, basic scientists, clinical researchers, ethicists, lawyers, educators, and religious leaders. Funded by the National Institutes of Health, the Oncofertility Consortium (OC) was formed to be a scientifically grounded, transparent, and altruistic resource, both intellectual and monetary, for building this new field of practice capable of addressing the unique needs of young patients with cancer. The OC has expanded its attention to include other nonmalignant conditions that can threaten fertility, and the work of the OC now extends around the globe, involving partners who together have created a community of shared effort, resources, and practices. The OC creates materials that are translated, disseminated, and amended by all participants in the field, and local programs of excellence have developed worldwide to accelerate the pace and improve the quality of oncofertility research and practice. Here we review the global oncofertility programs and the capacity building activities that strengthen these research and clinical programs, ultimately improving patient care.

Creating a Global Community of Practice for Oncofertility.

Fertility preservation in the cancer setting, known as oncofertility, is a field that requires cross-disciplinary interaction between physicians, basic scientists, clinical researchers, ethicists, lawyers, educators, and religious leaders. Funded by the National Institutes of Health, the Oncofertility Consortium (OC) was formed to be a scientifically grounded, transparent, and altruistic resource, both intellectual and monetary, for building this new field of practice capable of addressing the unique needs of young patients with cancer. The OC has expanded its attention to include other nonmalignant conditions that can threaten fertility, and the work of the OC now extends around the globe, involving partners who together have created a community of shared effort, resources, and practices. The OC creates materials that are translated, disseminated, and amended by all participants in the field, and local programs of excellence have developed worldwide to accelerate the pace and improve the quality of oncofertility research and practice. Here we review the global oncofertility programs and the capacity building activities that strengthen these research and clinical programs, ultimately improving patient care.

A new safe, simple and successful vitrification method for bovine and human blastocysts.

This study examined a new method for vitrification of blastocysts that is safe, simple and easy to learn and use. Current vitrification techniques have shortcomings that include the use of dimethyl sulphoxide, one of the more toxic cryoprotectants, and minute containers that are difficult to handle and are usually open to contamination. Cell handling and loading times are very short, which allows no room for user-associated errors and increases the difficulty of the procedure. This study describes a method of vitrification without these shortcomings. Human and bovine blastocysts were exposed to a series of three cryoprotectant solutions and loaded into a 0.25 ml sterile straw, heat sealed at both ends and vitrified. This technique allowed sufficient time for cryoprotectant exposure, loading, sealing and vitrification. Research blastocysts were thawed, cultured for 24 h, and stained for cell viability. The majority survived and on average had few lysed cells. In clinical studies from three different centres, 81.4% of vitrified blastocysts were intact after thawing. Out of 43 transfers with 76 blastocysts replaced, 44.7% implanted, 43.4% yielded a fetal heart beat, and a total of 32 babies have been delivered or are ongoing. The overall clinical pregnancy per transfer rate was 60.4%. The high survival rates and clinical pregnancy rates obtained with this new, safe and easy-to-use vitrification procedure are encouraging.

Interferência da salpingotripsia na vascularizaçäo ovariana e uterina. Estudo dopplerfluxométrico / Tubal ligation: effects on uterine and ovarian vascularization determined by doppler assessment

RETROSPECTIVA: a esterilizaçäo feminina pela técnica de salpingotripsia bilateral é um dos métodos mais comuns de controle de natalidade. Uma correlaçäo entre salpingotripsia (STB) e posterior aparecimento de distúrbios menstruais tem sido amplamente descrito na literatura. Esta associaçäo, entretanto, näo teve ainda um mecanismo biológico para confirmaçäo. OBJETIVOS: avaliar a influência da STB pela técnica de Pomeroy, no fluxo vascular das artérias ovarianas e uterinas, através do estudo Dopplerfluxométrico antes e após a cirurgia. MÉTODOS: foram estudadas 20 pacientes submetidas a STB por via laparotômica, e que realizaram exame de Dopplerfluxometria antes e após o procedimento cirúrgico, na fase folicular média. RESULTADOS: o índice de pulsatilidade (PI) da artéria uterina direita variou de 1,44 a 3,86 (média = 2,23) quando medido antes da cirurgia, e de 1,36 a 2,85 (média = 2,13) quando medido após a cirurgia. Para artéria uterina esquerda o PI variou de 1,67 a 3,17 (média = 2,17) e de 1,69 a 2,88 (média = 2,22), antes e após a cirurgia, respectivamente. A diferença observada näo foi estatisticamente significante. o PI da artéria ovariana direita variou de 1,38 a 3,48 (média=2,41), antes da cirurgia, e de 1,48 a 3,23 (média=2,29). Com relaçäo à artéria ovariana esquerda, o PI variou de 1,36 a 3,62 (média=2,54) e de 1,85 a 4,00 (média=2,61) antes e após a cirurgia, respectivamente. Também nesta análise, os resultados näo apresentaram diferença significante estatisticamente. CONCLUSöES: Nossos resultados demonstram que a esterilizaçäo tubárea pela técnica de Pomery näo induz alteraçöes imediatas no fluxo vascular, tanto nas artérias uterinas quanto nas ovarianas.