ABSTRACT
OBJECTIVE: To assess the long-term ovarian function and fertility after heterotopic autotransplantation of frozen-thawed ovarian tissue in cancer patients. DESIGN: Prospective clinical case series. SETTING: Academic medical center PATIENT(S): Four young cancer patients who completed cancer treatment. INTERVENTION(S): Cryopreserved ovarian tissue (2000-2002) was thawed and transplanted to the heterotopic site (between the rectus muscle and fascia) between 2002 and 2005. MAIN OUTCOME MEASURE(S): [1] Serial blood tests (FSH, LH, estradiol, progesterone, testosterone) and ultrasound examinations. [2] Oocyte retrieval and in vitro fertilization. RESULT(S): The hormonal profiles were consistent with the postmenopausal level before transplantation. The return of the ovarian function was evidenced by hormonal profiles between 12 and 20 weeks after transplantation. Three patients underwent a second transplantation, as restored ovarian function lasted only 3 to 5 months. After the second transplantation, long-term ovarian function (lasting for 15-41 months) was established in all three patients. Six oocytes (one GV, four MI, one MII) were retrieved from the grafts. Three MI oocytes were developed to full maturity in vitro. Four MII oocytes were fertilized and developed to the cleavage stage embryos (up to six-cell). CONCLUSION(S): Autotransplantation of frozen-thawed ovarian tissue to a heterotopic site restored long-term ovarian function (for >40 months), and showed a potential to restore fertility in cancer patients.
Subject(s)
Fertility , Ovary/physiology , Ovary/transplantation , Transplantation, Autologous/methods , Adult , Breast Neoplasms/surgery , Cryopreservation , Estradiol/blood , Female , Fertilization , Follicle Stimulating Hormone/blood , Follow-Up Studies , Humans , Hysterectomy , Oocyte Retrieval/methods , Organ Culture Techniques , Ovulation Induction/methods , Sperm Injections, Intracytoplasmic , Transplantation, Heterotopic/methods , Uterine Cervical Neoplasms/surgeryABSTRACT
To examine the effect of two types of resistant starch on blood glucose and insulin levels, colonic events, hypolipidemic actions and humoral immune responses, Sprague-Dawley streptozotocin-induced diabetic rats were fed diet containing resistant starch from corn or rice. The marked body weight loss by inducing diabetes was not recovered by feeding resistant starch, even though there are no differences in food intakes compared to the non-diabetic control rats. No significant effect of resistant starch feeding on blood glucose and insulin was found. Even though the length of small intestines, and cecum, colon and rectum together with the tissue weight of cecum were not affected by feeding resistant starch, the intestinal transit time was markedly shortened by both types of resistant starch and resistant starch from corn had a more pronounced effect. The short chain fatty acids in the intestinal contents did not appear to be different among the groups. Nonetheless, both of resistant starch from corn and rice significantly lowered plasma total lipid and cholesterol concentrations compared to the diabetic control. The total liver cholesterol lowering effect was observed with resistant starch from rice. Neither immunoglobulin G nor C(3) were influenced by resistant starch.