Ovarian tissue cryopreservation for fertility preservation before hematopoietic stem cell transplantation in patients with sickle cell disease: safety, ovarian function follow-up, and results of ovarian tissue transplantation

期刊论文
发表日期：

2024年2月15日

查看全文

Mitawa Millin Missontsa,
Françoise Bernaudin,
Anne Fortin,
Nathalie Dhédin,
Corinne Pondarré,
Karima Yakouben,
Bénédicte Neven,
Martin Castelle,
Marina Cavazzana,
Harry Lezeau,
Matthieu Peycelon,
Annabel Paye-Jaouen,
Jeremy Sroussi,
Tamara Diesch-Furlanetto,
Virginie Barraud-Lange,
Sabine Sarnacki,
Mony Fahd,
Isis Marchand,
Clémence Delcour,
Dominique Vexiau,
Jean-Benoît Arlet,
Annie Kamdem,
Cécile Arnaud,
Jean-Hugues Dalle,
Catherine Poirot

摘要

Purpose

To describe the experience of performing ovarian tissue cryopreservation (OTC) before hematopoietic stem cell transplantation (HSCT), among girls/women with severe sickle cell disease (SCD)(SS or S/β⁰-thalassemia) who are, besides the usual surgical risk, at risk of SCD-related complications during the fertility preservation procedure for improving their counseling and management.

Methods

This retrospective study included 75 patients (girls/women) with SCD who have had OTC before myeloablative conditioning regimen (MAC) for HSCT. Characteristics of patients and data on OTC, ovarian status follow-up, and results of ovarian tissue transplantation (OTT) were collected in medical records.

Results

At OTC, the median (IQR 25–75; range) age of the patients was 9.6 (6.9–14.1; 3.6–28.3) years, 56/75 were prepubertal, and no SCD or surgery-related complications occurred. The median follow-up post-HSCT was > 9 years. At the last follow-up, among prepubertal patients at HSCT, 26/56 were ≥ 15 years old and presented with a premature ovarian insufficiency (POI), except 2, including the patient who had received an OTT to induce puberty. Eight were 13–15 years old and presented for POI. The remaining 22 patients were under 13. Among the 19 patients who were menarche at HSCT, 2 died 6 months post-HSCT and we do not have ovarian function follow-up for the other 2 patients. All the remaining patients (n = 15) had POI. Five patients had OTT. All had a return of ovarian function. One patient gave birth to a healthy baby.

Conclusion

OTC is a safe fertility preservation technique and could be offered before MAC independent of the patient’s age.