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1.
Reprod Biomed Online ; 49(6): 104374, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-39342810

RESUMO

RESEARCH QUESTION: What is the experience and mid- and long-term andrological health follow-up of (pre)pubertal males who have undergone testicular tissue freezing (TTF)? DESIGN: This single-centre longitudinal retrospective cohort study reports on the mid- and long-term andrological health follow-up of (pre)pubertal males and young adults who underwent TTF for fertility preservation between January 2007 and December 2018. Medical characteristics and questionnaire data collected more than 18 months after TTF were analysed. RESULTS: Thirty-six patients were revisited during a medical follow-up consultation. During follow-up after TTF, 72.7% of patients could not recollect their counselling consultation prior to TTF but 42.4% of them found information about the TTF process useful and sufficient. Parents' or legal guardians' feedback was more positive about the counselling consultation and the TTF process. After TTF and treatment, the majority of patients (76.9%) who provided a semen sample had non-obstructive azoospermia. Higher serum concentrations of FSH and LH and lower serum concentrations of inhibin B were associated with non-obstructive azoospermia compared with patients with oligozoospermia (P = 0.0182, P = 0.0245 and P = 0.0140 respectively). During cancer treatment, about half of pubertal patients reported sexual dysfunction, decreasing to approximately 20% after treatment. However, two patients had children using sperm donation and one patient had a child through natural pregnancy. CONCLUSIONS: The involvement of parents or legal guardians is crucial in the decision-making process for fertility preservation in (pre)pubertal boys. Regular follow-up, including the use of questionnaires, is essential to provide guidance for fertility preservation programmes and information on fertility restoration options and to address the psychosocial aspects of fertility preservation.

2.
Sensors (Basel) ; 24(11)2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38894444

RESUMO

This work describes a sapphire cryo-applicator with the ability to sense tissue freezing depth during cryosurgery by illumination of tissue and analyzing diffuse optical signals in a steady-state regime. The applicator was manufactured by the crystal growth technique and has several spatially resolved internal channels for accommodating optical fibers. The method of reconstructing freezing depth proposed in this work requires one illumination and two detection channels. The analysis of the detected intensities yields the estimation of the time evolution of the effective attenuation coefficient, which is compared with the theoretically calculated values obtained for a number of combinations of tissue parameters. The experimental test of the proposed applicator and approach for freezing depth reconstruction was performed using gelatin-based tissue phantom and rat liver tissue in vivo. It revealed the ability to estimate depth up to 8 mm. The in vivo study confirmed the feasibility of the applicator to sense the freezing depth of living tissues despite the possible diversity of their optical parameters. The results justify the potential of the described design of a sapphire instrument for cryosurgery.


Assuntos
Óxido de Alumínio , Criocirurgia , Congelamento , Fígado , Imagens de Fantasmas , Animais , Criocirurgia/métodos , Ratos , Fígado/cirurgia , Fígado/diagnóstico por imagem , Óxido de Alumínio/química
3.
Anal Chim Acta ; 1312: 342758, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38834268

RESUMO

BACKGROUND: The selection of the sample treatment strategy is a crucial step in the metabolomics workflow. Solid phase microextraction (SPME) is a sample processing methodology with great potential for use in untargeted metabolomics of tissue samples. However, its utilization is not as widespread as other standard protocols involving steps of tissue collection, metabolism quenching, homogenization, and extraction of metabolites by solvents. Since SPME allows us to perform all these steps in one action in tissue samples, in addition to other advantages, it is necessary to know whether this methodology produces similar or comparable metabolome and lipidome coverage and performance to classical methods. RESULTS: SPME and homogenization with solid-liquid extraction (Homo-SLE) sample treatment methods were applied to healthy murine kidney tissue, followed by comprehensive metabolomics and lipidomics analyses. In addition, it has been tested whether freezing and storage of the tissue causes alterations in the renal metabolome and lipidome, so the analyses were performed on fresh and frozen tissue samples Lipidomics analysis revealed the exclusive presence of different structural membrane and intracellular lipids in the Homo-SLE group. Conversely, all annotated metabolites were detected in both groups. Notably, the freezing of the sample mainly causes a decrease in the levels of most lipid species and an increase in metabolites such as amino acids, purines, and pyrimidines. These alterations are principally detected in a statistically significant way by SPME methodology. Finally, the samples of both methodologies show a positive correlation in all the analyses. SIGNIFICANCE: These results demonstrate that in SPME processing, as long as the fundamentals of non-exhaustive extraction in a pre-equilibrium kinetic regime, extraction in a tissue localized area, the chemistry of the fiber coating and non-homogenization of the tissue are taken into account, is an excellent method to use in kidney tissue metabolomics; since this methodology presents an easy-to-use, efficient, and less invasive approach that simplifies the different sample processing steps.


Assuntos
Rim , Metabolômica , Microextração em Fase Sólida , Microextração em Fase Sólida/métodos , Animais , Metabolômica/métodos , Rim/metabolismo , Rim/química , Camundongos , Extração Líquido-Líquido/métodos , Metaboloma , Masculino , Camundongos Endogâmicos C57BL
4.
Hum Reprod ; 38(11): 2105-2118, 2023 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-37674325

RESUMO

STUDY QUESTION: What is the impact of low- or moderate-risk gonadotoxic chemotherapy received prior to testicular tissue freezing (TTF), and of the cancer itself, on spermatogonia quantity in testicular tissue from (pre)pubertal boys? SUMMARY ANSWER: Vincristine, when associated with alkylating agents, has an additional adverse effect on spermatogonia quantity, while carboplatin has no individual contribution to spermatogonia quantity, in testicular tissue of (pre)pubertal boys, when compared to patients who have received non-alkylating chemotherapy. WHAT IS KNOWN ALREADY: The improved survival rates after cancer treatment necessitate the inclusion of fertility preservation procedures as part of the comprehensive care for patients, taking into consideration their age. Sperm cryopreservation is an established procedure in post-pubertal males while the TTF proposed for (pre)pubertal boys remains experimental. Several studies exploring testicular tissue of (pre)pubertal boys after TTF have examined the tubular fertility index (TFI, percentage of seminiferous tubule cross-sections containing spermatogonia) and the number of spermatogonia per seminiferous tubule cross-section (S/T). All studies have demonstrated that TFI and S/T always decrease after the introduction of chemotherapeutic agents, especially those which carry high gonadotoxic risks such as alkylating agents. STUDY DESIGN, SIZE, DURATION: Testicular tissue samples from 79 (pre)pubertal boys diagnosed with cancer (from 6 months to 16 years of age) were cryopreserved between May 2009 and June 2014. Their medical diagnoses and previous chemotherapy exposures were recorded. We examined histological sections of (pre)pubertal testicular tissue to elucidate whether the chemotherapy or the primary diagnosis affects mainly TFI and S/T. PARTICIPANTS/MATERIALS, SETTING, METHODS: (Pre)pubertal boys with cancer diagnosis who had been offered TTF prior to conditioning treatment for hematopoietic stem cell transplantation were included in the study. All the patients had previously received chemotherapy with low- or moderate-risk for future fertility. We have selected patients for whom the information on the chemotherapy received was complete. The quantity of spermatogonia and quality of testicular tissue were assessed by both morphological and immunohistochemical analyses. MAIN RESULTS AND THE ROLE OF CHANCE: A significant reduction in the number of spermatogonia was observed in boys treated with alkylating agents. The mean S/T values in boys exposed to alkylating agents were significantly lower compared to boys exposed to non-alkylating agents (P = 0.018). In contrast, no difference was observed for patients treated with carboplatin as the sole administered alkylating agent compared to the group of patients exposed to non-alkylating agents. We observed an increase of S/T with age in the group of patients who did not receive any alkylating agent and a decrease of S/T with age when patients received alkylating agents included in the cyclophosphamide equivalent dose (CED) formula (r = 0.6166, P = 0.0434; r = -0.3759, P = 0.0036, respectively). The TFI and S/T decreased further in the group of patients who received vincristine in combination with alkylating agents (decrease of 22.4%, P = 0.0049 and P < 0.0001, respectively), but in this group the CED was also increased significantly (P < 0.0001). Multivariate analysis, after CED adjustment, showed the persistence of a decrease in TFI correlated with vincristine administration (P = 0.02). LIMITATIONS, REASONS FOR CAUTION: This is a descriptive study of testicular tissues obtained from (pre)pubertal boys who were at risk of infertility. The study population is quite heterogeneous, with a small number of patients in each sub-group. Our results are based on comparisons between patients receiving alkylating agents compared to patients receiving non-alkylating agents rather than chemotherapy-naive patients. The French national guidelines for fertility preservation in cancer patients recommend TTF before highly gonadotoxic treatment. Therefore, all the patients had received low- or moderate-risk gonadotoxic chemotherapy before TTF. Access to testicular tissue samples from chemotherapy-naive patients with comparable histological types of cancer was not possible. The functionality of spermatogonia and somatic cells could not be tested by transplantation or in vitro maturation due to limited sample sizes. WIDER IMPLICATIONS OF THE FINDINGS: This study summarizes the spermatogonial quantity of (pre)pubertal boys prior to TTF. We confirmed a negative correlation between the cumulative exposure to alkylating agents and spermatogonial quantity. In addition, the synergistic use of vincristine in combination with alkylating agents showed a cumulative deleterious effect on the TFI. For patients for whom fertility preservation is indicated, TTF should be proposed for chemotherapy with a predicted CED above 4000 mg/m2. However, the data obtained from vincristine and carboplatin use should be confirmed in a subsequent study including more patients. STUDY FUNDING/COMPETING INTEREST(S): This study had financial support from a French national research grant PHRC No. 2008/071/HP obtained by the French Institute of Cancer and the French Healthcare Organization. The sponsors played no role in the study. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.


Assuntos
Preservação da Fertilidade , Neoplasias , Humanos , Masculino , Espermatogônias/metabolismo , Testículo/metabolismo , Congelamento , Vincristina/metabolismo , Carboplatina/metabolismo , Sêmen , Preservação da Fertilidade/métodos , Neoplasias/complicações , Alquilantes/metabolismo
5.
Orv Hetil ; 164(29): 1134-1145, 2023 Jul 23.
Artigo em Húngaro | MEDLINE | ID: mdl-37481767

RESUMO

In Hungary, an average of 2066 women under the age of 40 are diagnosed with cancer each year according to data from the National Cancer Registry. Approximately two-thirds of these patients require gonadotoxic treatment for their disease, which could potentially reduce their chances of future conception and childbirth. Currently, there are no professional guidelines on fertility preservation in Hungary, however, it is important to inform patients about their options. In our previous paper, we presented the gonadotoxic effects of oncotherapies and the currently available fertility preservation techniques. This second paper provides current treatment methods and recommends fertility preservation techniques in different cancer types. The success of an oncofertility program relies heavily on the effective communication and collaboration between oncologists and reproductive specialists involved in fertility preservation. This paper may be the first step in elaborating a guideline towards improving access to oncofertility services and ultimately improving the quality of life for young cancer survivors in Hungary. Orv Hetil. 2023; 164(29): 1134-1145.


Assuntos
Preservação da Fertilidade , Neoplasias , Gravidez , Humanos , Feminino , Preservação da Fertilidade/métodos , Qualidade de Vida , Neoplasias/complicações , Neoplasias/terapia , Parto , Reprodução
6.
Orv Hetil ; 164(28): 1094-1101, 2023 Jul 16.
Artigo em Húngaro | MEDLINE | ID: mdl-37454332

RESUMO

The incidence of cancer increases with age and as family planning is being delayed, there is a growing number of cancer patients whose fertility may be affected by oncological treatments. International guidelines recommend that all reproductive age cancer patients, including adolescent patients, should be referred for fertility preservation consultation, and if necessary, fertility preservation procedures should be performed. Fertility preservation enables cancer survivors to offer a chance for biological parenthood after recovery. In this review, the gonadotoxic effects of oncological therapies and the fertility preservation possibilities for female cancer patients based on international recommendations and literature are discussed. Our next review will provide detailed information on the special fertility preservation possibilities for different cancer types. The two reviews may help to elaborate a national guidance. Orv Hetil. 2023; 164(28): 1094-1101.


Assuntos
Preservação da Fertilidade , Neoplasias , Adolescente , Humanos , Feminino , Preservação da Fertilidade/métodos , Criopreservação/métodos , Neoplasias/complicações , Neoplasias/terapia , Fertilidade , Reprodução
7.
Cell Tissue Bank ; 24(2): 435-447, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36309911

RESUMO

Availability of molecularly intact biospecimens is essential in genetic diagnostics to obtain credible results. Integrity of nucleic acids (particularly RNA) may be compromised at various steps of tissue handling, and affected by factors such as time to freeze, freezing technique and storing temperature. At the same time, freezing and storing of the biological material should be feasible and safe for the operator. Here, we compared quality of DNA and RNA from biospecimens derived from different organs (breast, colon, adrenal glands, testes, rectum and uterus) frozen either using dry ice-cooled isopentane or with FlashFREEZE unit, in order to verify if the latter is suitable for routine use in biobanking. Implementing FlashFREEZE device would enable us to limit the use of isopentane, which is potentially toxic and environmentally harmful, whilst facilitate standardization of sample freezing time. We considered factors such RNA and DNA yield and purity. Furthermore, RNA integrity and RNA/DNA performance in routine analyses, such as qPCR, next generation sequencing or microarray, were also assessed. Our results indicate that freezing of tissue samples either with FlashFREEZE unit or isopentane ensures biological material with comparable expression profiles and DNA mutation status, indicating that RNA and DNA of similar quality can be extracted from both. Therefore, our findings support the use of the FlashFREEZE device in routine use for biobanking purposes.


Assuntos
Criopreservação , Humanos , Bancos de Espécimes Biológicos , Criopreservação/instrumentação , Criopreservação/métodos , Biópsia , Neoplasias/química , Neoplasias/patologia , RNA/análise , DNA/análise
8.
Gynecol Obstet Fertil Senol ; 50(12): 797-804, 2022 12.
Artigo em Francês | MEDLINE | ID: mdl-36183988

RESUMO

The evolution of medical techniques as well as legislative changes currently allow to propose fertility preservation strategies in the context of transidentity. During "female to male" transition, androgen therapy has an impact on gonadal function since it usually induces a blockage of ovulation with amenorrhea. Although this effect is reversible when treatment is stopped, the possible long-term effects of testosterone treatment on future fertility or health of future children are poorly known. In addition, transitional surgeries definitely compromise fecundity when they include bilateral ovariectomy and/or hysterectomy. Yet, although long ignored or poorly expressed, the desire for parenthood is a reality in transgender men. Fertility preservation options in FtM transition rely on oocyte or ovarian tissue cryopreservation. The purpose of this review is to provide an overview of the literature regarding fertility preservation in transgender men. Although series remain limited, the increase in the number of recently published articles reflects the interest in improving the management of fertility issues in transgender men.


Assuntos
Preservação da Fertilidade , Infertilidade , Masculino , Feminino , Humanos , Preservação da Fertilidade/métodos , Criopreservação/métodos , Oócitos , Ovariectomia
9.
Eur J Obstet Gynecol Reprod Biol ; 271: 210-213, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35228092

RESUMO

Space travel has different effects on the reproductive capacity of women compared to men. The radiation exposure intrinsic to deep space travel causes destruction of some of a woman's primordial follicles. Data suggests that a typical Mars mission may reduce a women's ovarian reserve by about 50%. This has consequences to a woman's reproductive capacity and, more significantly, decreases the time interval to her menopause. A reduced time interval to menopause is associated with earlier mortality. Estrogen replacement therapy and cryopreservation of a female astronaut's oocytes may be used to address these issues. However, cortical tissue freezing provides advantages to more directly compensate for these workplace complications. Cortical tissue freezing especially provides advantages if there are plans to reproduce in an extraterrestrial location.


Assuntos
Reserva Ovariana , Voo Espacial , Astronautas , Criopreservação , Feminino , Humanos , Menopausa , Folículo Ovariano
10.
Gynecol Oncol ; 161(3): 817-824, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33812696

RESUMO

OBJECTIVE: To describe strategy and results of fertility preservation (FP) in patients with malignant and borderline ovarian tumors. METHODS: Consecutive cohort study of 43 women with malignant or borderline ovarian tumors who underwent FP between February 2013 and July 2019. The study was conducted in national expert center in Tenon University Hospital, Sorbonne University: French ESGO-certified ovarian cancer center and pregnancy-associated cancer network (CALG). Main outcome measure was FP technique proposed by multidisciplinary committee, FP technique used, time after surgery, number of fragments, histology and follicle density (if ovarian tissue freezing), number of expected, retrieved and frozen oocytes (if ovarian stimulation). RESULTS: Pathological diagnosis was malignant epithelial ovarian tumor in five women (11.6%), rare malignant ovarian tumor in 14 (32.6%), borderline in 24 (55.8%), and mostly unilateral (79.1%) and stage I (76.7%). Mean age at diagnosis was 26.8 ± 6.9 years and mean tumor size 109.7 ± 61 mm. Before FP, mean AFC was 11.0 ± 6.1 and AMH levels were 2.7 ± 4.6 ng/mL. Six ovarian tissue-freezing procedures were performed (offered to 13). Twenty-four procedures of ovarian stimulation and oocyte freezing were performed after surgical treatment for 19 women (offered to 28) with a median interval of 188 days. The mean number of mature oocytes retrieved per stimulation was 12.4 ± 12.8. At least 10 mature oocytes were frozen for 52.6% of the women. No FP was offered to five women. CONCLUSION: Oocyte and ovarian tissue cryopreservation should be offered to patients with malignant and borderline ovarian tumors. More data are needed to confirm ovarian stimulation and ovarian tissue grafting safety.


Assuntos
Carcinoma Epitelial do Ovário/terapia , Preservação da Fertilidade , Neoplasias Ovarianas/terapia , Adulto , Feminino , França , Humanos , Gravidez , Resultado da Gravidez , Universidades
11.
J Biomech Eng ; 143(2)2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32909598

RESUMO

A novel method for positioning and operating needle-like cryo-surgical probes in 2D convex target areas is presented. The method is based on the recorded dynamic performance of a single probe, termed "unit circle," (UC) embedded in a semi-infinite, tissue-like medium. Up to 15 cryo-probes, inserted into the same depth, are operated uniformly for 2-5 min. A predetermined number of probes are rearranged inside the target area until a "tight configuration" is obtained. The probes are initially arranged inside the target area such that the "lethal temperature" circles produced by them are tangent to its contour and to both adjacent lethal temperature circles. Subsequently, all probes are repositioned inwardly, each at a specific distance that depends on the local radius of curvature of the target area. Resulting total "defect areas"-internal and external-for a number of demonstrated cases, amounted to between 2.5% and 7.6% of the target area. The lower values of the defect areas were obtained with increasing numbers of inserted probes coupled with shorter operating times. Possible freezing damages to regions beyond the target area were reduced by up to about 30% for these cases. Similar results were obtained for a case of combined convex-concave target area, treated with additional, externally inserted, heating probes.


Assuntos
Criocirurgia , Agulhas , Temperatura
12.
Reprod Biomed Online ; 41(6): 1070-1083, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33036927

RESUMO

RESEARCH QUESTION: Can specimen types (cells versus tissues) and additive cryoprotectant agents contribute to efficient cryopreservation of primate spermatogonial stem cells (SSC)? DESIGN: Testicular tissues or cells from four prepubertal monkeys were used in this study. The freezing efficacy of testicular tissue was compared with cell suspensions using conventional freezing media (1.4 mol/l dimethyl sulfoxide [DMSO]) and the efficacy of cryoprotectant additives (1.4 mol/l DMSO combined with trehalose 200 mmol/l, hypotaurine 14 mmol/l, necrostatin-1 50 µmol/l or melatonin 100 µmol/l) was evaluated in testicular tissue freezing. RESULTS: The survival rate (46.0 ± 4.8% versus 33.7 ± 6.0%; P = 0.0286) and number of recovered cells (5.0 ± 1.5 × 106 cells/g versus 0.7 ± 0.8 × 106 cells/g; P = 0.0286) were significantly higher in frozen tissues than in frozen cell suspensions. After tissue freezing, a higher number of recovered PGP9.5+ cells were observed with 200 mmol/l trehalose treatment than in DMSO controls (2.4 ± 0.6 × 106 cells/g versus 1.1 ± 0.3 × 106 cells/g; P = 0.0164). Normal establishment of donor-derived colony was observed in SSC after tissue freezing with 200 mmol/l trehalose. CONCLUSIONS: Testicular tissue freezing is more effective than single cell suspension freezing for higher recovery of undifferentiated spermatogonia. Moreover, it was verified that slow freezing using 200 mmol/l trehalose, 1.4 mol/l DMSO and 10% KnockOut™ Serum Replacement in Dulbecco's phosphate-buffered saline is an effective cryopreservation protocol for primate testicular tissue.


Assuntos
Criopreservação/métodos , Preservação da Fertilidade/métodos , Macaca fascicularis , Animais , Sobrevivência Celular/efeitos dos fármacos , Criopreservação/veterinária , Crioprotetores/farmacologia , Fertilidade/fisiologia , Preservação da Fertilidade/veterinária , Congelamento , Macaca fascicularis/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Preservação do Sêmen/métodos , Preservação do Sêmen/veterinária , Maturidade Sexual/fisiologia , Espermatogônias , Testículo , Transplante Heterólogo/métodos , Transplante Heterólogo/veterinária
13.
Hum Reprod Open ; 2020(3): hoaa016, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32529047

RESUMO

BACKGROUND: Infertility is an important side effect of treatments used for cancer and other non-malignant conditions in males. This may be due to the loss of spermatogonial stem cells (SSCs) and/or altered functionality of testicular somatic cells (e.g. Sertoli cells, Leydig cells). Whereas sperm cryopreservation is the first-line procedure to preserve fertility in post-pubertal males, this option does not exist for prepubertal boys. For patients unable to produce sperm and at high risk of losing their fertility, testicular tissue freezing is now proposed as an alternative experimental option to safeguard their fertility. OBJECTIVE AND RATIONALE: With this review, we aim to provide an update on clinical practices and experimental methods, as well as to describe patient management inclusion strategies used to preserve and restore the fertility of prepubertal boys at high risk of fertility loss. SEARCH METHODS: Based on the expertise of the participating centres and a literature search of the progress in clinical practices, patient management strategies and experimental methods used to preserve and restore the fertility of prepubertal boys at high risk of fertility loss were identified. In addition, a survey was conducted amongst European and North American centres/networks that have published papers on their testicular tissue banking activity. OUTCOMES: Since the first publication on murine SSC transplantation in 1994, remarkable progress has been made towards clinical application: cryopreservation protocols for testicular tissue have been developed in animal models and are now offered to patients in clinics as a still experimental procedure. Transplantation methods have been adapted for human testis, and the efficiency and safety of the technique are being evaluated in mouse and primate models. However, important practical, medical and ethical issues must be resolved before fertility restoration can be applied in the clinic.Since the previous survey conducted in 2012, the implementation of testicular tissue cryopreservation as a means to preserve the fertility of prepubertal boys has increased. Data have been collected from 24 co-ordinating centres worldwide, which are actively offering testis tissue cryobanking to safeguard the future fertility of boys. More than 1033 young patients (age range 3 months to 18 years) have already undergone testicular tissue retrieval and storage for fertility preservation. LIMITATIONS REASONS FOR CAUTION: The review does not include the data of all reproductive centres worldwide. Other centres might be offering testicular tissue cryopreservation. Therefore, the numbers might be not representative for the entire field in reproductive medicine and biology worldwide. The key ethical issue regarding fertility preservation in prepubertal boys remains the experimental nature of the intervention. WIDER IMPLICATIONS: The revised procedures can be implemented by the multi-disciplinary teams offering and/or developing treatment strategies to preserve the fertility of prepubertal boys who have a high risk of fertility loss. STUDY FUNDING/COMPETING INTERESTS: The work was funded by ESHRE. None of the authors has a conflict of interest.

14.
Climacteric ; 22(6): 579-583, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31079511

RESUMO

Women are surviving cancer in greater numbers. For this population, fertility becomes an important issue to be discussed before treatment to ensure maximal chances of fertility after treatment completion. Options for fertility preservation include egg or embryo freezing, ovarian tissue freezing, as well as gonadotropin releasing hormone analogs. The option for each individual patient will depend on the type of cancer, its aggressiveness and the time before treatment needs to commence, the type of treatment, the health of the patient, and whether the patient has a male partner.


Assuntos
Sobreviventes de Câncer , Preservação da Fertilidade , Infertilidade Feminina , Feminino , Humanos
15.
Fertil Steril ; 110(1): 19-24, 2018 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-29980258

RESUMO

In vitro fertilization (IVF) began in Melbourne in 1970 when Carl Wood founded a research group at the Queen Victoria Hospital. The group reported the first biochemical pregnancy from a transferred IVF embryo in 1973. The group included the Royal Women's Hospital Melbourne, and they were the first to report confirmation of the British group's pregnancies with the use of IVF in natural cycles in 1980. The group then split, and the Monash group pursued fertility drug-induced multiple follicle growth in controlled ovulatory cycles and demonstrated for the first time that they could achieve multiple pregnancies in 1980-1981. This became the basis of a sustainable procedure for treating infertile patients. Successful embryo freezing and thawing methods resulted in pregnancies for the first time and were adopted to cryopreserve excess embryos produced after superovulation. Embryo donation methods were devised for anovulatory patients and were the first reported use of oocyte in vitro maturation techniques (IVM) for polycystic ovarian syndrome patients. Sperm microinjection techniques were pioneered for enabling fertilization for severely infertile men, and micromanipulative techniques were published for embryo biopsy for potential use in preimplantation genetic diagnosis (PGD) for patients with inheritable genetic diseases. The latter research programs were hampered by creation of restrictive embryo research laws in the State of Victoria, handicapping their timely clinical applications. Work on cryopreservation of ovarian tissue for cancer patients enabled clinical application of this for patients at risk of loss of fertility. Vitrification was developed as an alternative to freezing for oocytes and embryos, and this has now replaced the original slow cooling methods. Blastocyst culture systems were devised and optimized to improve IVF success and PGD.


Assuntos
Fertilização in vitro/história , Austrália , Técnicas de Cultura Embrionária/história , Técnicas de Cultura Embrionária/métodos , Feminino , Fertilização in vitro/métodos , Fertilização in vitro/tendências , História do Século XX , História do Século XXI , Humanos , Técnicas de Maturação in Vitro de Oócitos/história , Técnicas de Maturação in Vitro de Oócitos/métodos , Recém-Nascido , Masculino , Gravidez
16.
JBRA Assist Reprod ; 20(1): 41-3, 2016 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-27203306

RESUMO

Mesenteric lymphadenitis is a clinical condition that affects mostly children and teenagers. Its symptoms include fever, severe abdominal pain, nausea, and, in some cases, diarrhea, constipation, and acute abdomen. This paper describes the case of a 16-year-old patient with mesenteric lymphadenitis submitted to an exploratory laparoscopy for suppurative lymph nodes that evolved to a drastic reduction of ovarian reserve. Because of the patients age, she was offered cryopreservation of her ovarian tissue.


Assuntos
Infertilidade Feminina , Linfadenite Mesentérica , Reserva Ovariana/fisiologia , Abdome Agudo/diagnóstico por imagem , Abdome Agudo/etiologia , Adolescente , Criopreservação , Feminino , Humanos , Infertilidade Feminina/etiologia , Infertilidade Feminina/terapia , Linfadenite Mesentérica/complicações , Linfadenite Mesentérica/diagnóstico por imagem , Linfadenite Mesentérica/cirurgia , Ultrassonografia
17.
Hum Pathol ; 45(1): 143-52, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24321523

RESUMO

Frozen human tissues are necessary for research purposes, but tissue banking methods have not changed for more than a decade. Many institutions use cryovial tubes or plastic molds with an optimal cutting temperature compound. However, these methods are associated with several problems, such as samples sticking to one another and the need for a larger storing space. We established an efficient tissue freezing and storing procedure ("tissue tablet method") applicable to both molecular analysis and frozen tissue microarray. Tissue samples were chopped into tiny fragments and embedded into tablet-shaped frozen optimal cutting temperature compound using our original tissue-freezing plate. These tablets can be sectioned and stored in cryovial tubes. We compared the tissue quality of tablet-shaped samples with that of conventional optimal cutting temperature blocks and found no significant difference between them. Tissue microarray is a key method to utilize tissue-banking specimens. However, most tissue microarrays require the coring out of cylindrically shaped tissues from formalin-fixed, paraffin-embedded tissue blocks. Antigenic changes and mRNA degradation are frequently observed with formalin-fixed, paraffin-embedded samples. Therefore, we have applied tablet-shaped samples to construct frozen tissue microarrays with our original mounting base. Constructed tissue microarray sections showed good morphology without obvious artifact and good immunohistochemistry and in situ hybridization results. These results suggest that the quality of arrayed samples was sufficiently appropriate for research purposes. In conclusion, the tissue tablet method and frozen tissue microarray procedure can save time, provides easy tissue handling and processing, and satisfies the demands of research methodologies and tissue banking.


Assuntos
Criopreservação/instrumentação , Criopreservação/métodos , Análise Serial de Tecidos/métodos , Bancos de Tecidos , Humanos , Immunoblotting , Imuno-Histoquímica , Hibridização In Situ , Reação em Cadeia da Polimerase Via Transcriptase Reversa
18.
Immunobiology ; 218(9): 1131-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23642836

RESUMO

Tissue loss after myocardial ischemia with reperfusion (MI/R) is in part conveyed by neutrophil recruitment to post-ischemic myocardium. Strategies to prevent reperfusion injury would help to limit myocardial damage. The receptor for activated complement factor 5 (C5aR) plays a prominent role in inflammation. We examine the effects of C5aR-deficiency on reperfusion injury after MI/R. C5aR(-/-)-mice and their C57BL/6- (WT) littermates underwent transient myocardial ischemia followed by different time points of reperfusion. Infarct size and leukocyte infiltration were determined. Expression of C5aR, inflammatory cytokines and adhesion molecules were analyzed by real-time RT-PCR. Leukocyte-endothelial interactions were assessed by low-shear adhesion- and transmigration-assays in vitro. Myocardial C5aR mRNA expression was 2.8-fold increased by ischemia. Infarct size per area-at-risk and leukocyte recruitment into infarctions were reduced in C5aR(-/-)-compared to WT-mice as well as in WT mice treated with the C5aR-antagonist JPE1375. IL-6, IL-1ß, ICAM-1 and VCAM-1 expression were not different, while TNFα expression was reduced in C5aR(-/-)-mice after MI/R. In vitro, C5aR on leukocytes is required for effective transendothelial migration but not adhesion. Expression of MMP9 and JAM-A, molecules that are involved in leukocyte transmigration, were reduced in C5aR(-/-) mice in vivo. Genetic C5aR deficiency blunts the inflammatory response in murine MI/R resulting in reduced inflammatory cell recruitment, which is due to a C5aR-dependent effect on leukocyte transmigration across inflamed endothelium into the ischemic myocardium. This effect could be related to MMP9- and JAM-A expression in response to ischemia and reperfusion.


Assuntos
Infarto do Miocárdio/imunologia , Traumatismo por Reperfusão Miocárdica/complicações , Miocárdio/metabolismo , Neutrófilos/imunologia , Receptor da Anafilatoxina C5a/metabolismo , Animais , Moléculas de Adesão Celular/genética , Moléculas de Adesão Celular/metabolismo , Movimento Celular/genética , Células Cultivadas , Regulação da Expressão Gênica/genética , Humanos , Metaloproteinase 9 da Matriz/genética , Metaloproteinase 9 da Matriz/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Infarto do Miocárdio/complicações , Traumatismo por Reperfusão Miocárdica/etiologia , Miocárdio/imunologia , Miocárdio/patologia , Receptor da Anafilatoxina C5a/genética , Receptor da Anafilatoxina C5a/imunologia , Receptores de Superfície Celular/genética , Receptores de Superfície Celular/metabolismo , Migração Transendotelial e Transepitelial/genética , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo
19.
J Neurosci Methods ; 218(2): 206-13, 2013 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-23541995

RESUMO

A major challenge in the histological sectioning of brain tissue is achieving accurate alignment in the standard coronal, horizontal, or sagittal planes. Correct alignment is desirable for ease of subsequent analysis and is a prerequisite for computational registration and algorithm-based quantification of experimental data. We have developed a simple and low-cost technique for whole-brain cryosectioning of rodent brains that reliably results in a precise alignment of stereotactic coordinates. The system utilises a 3-D printed model of a mouse brain to create a tailored cavity that is used to align and support the brain during freezing. The alignment of the frozen block is achieved in relation to the fixed edge of the mold. The system also allows for two brains to be frozen and sectioned simultaneously. System components, procedural steps, and examples of the end results are presented.


Assuntos
Encéfalo , Criopreservação/métodos , Crioultramicrotomia/métodos , Animais , Criopreservação/economia , Criopreservação/instrumentação , Crioultramicrotomia/economia , Crioultramicrotomia/instrumentação , Camundongos , Camundongos Endogâmicos C57BL , Técnicas Estereotáxicas/economia , Técnicas Estereotáxicas/instrumentação , Técnicas Estereotáxicas/normas
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