Possible improvements in human ovarian grafting by various host and graft treatments.
Study Goal
The researchers aimed to determine whether melatonin, alone or in combination with other treatments, improves graft survival and reduces follicular loss in ovarian tissue transplantation.
Results Summary
Host treatment with melatonin and graft incubation with HA-rich biological glue, especially when combined with VEGF-A and vitamin E, significantly improved graft survival, reduced apoptosis, and minimized follicular loss compared to untreated grafts.
Population
Young cancer patients undergoing ovarian tissue cryopreservation for fertility preservation.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
host treatment with melatonin before and after grafting | no change | graft size | human ovarian tissue grafts in immunodeficient mice | - | retained their original size | #1 |
graft incubation with HA-rich biological glue before transplantation | no change | graft size | human ovarian tissue grafts in immunodeficient mice | - | retained their original size | #2 |
host treatment with melatonin | decrease | apoptosis | human ovarian tissue grafts in immunodeficient mice | - | significantly lower | #3 |
graft incubation with HA-rich biological glue plus VEGF-A and vitamin E | decrease | apoptosis | human ovarian tissue grafts in immunodeficient mice | - | significantly lower | #4 |
host treatment with melatonin and graft incubation with HA-rich biological glue plus VEGF-A and vitamin E (Group G) | decrease | apoptosis | human ovarian tissue grafts in immunodeficient mice | - | specifically low | #5 |
untreated | increase | atretic follicles | human ovarian tissue grafts in immunodeficient mice | - | significantly more | #6 |
host treatment with melatonin or graft incubation with HA-rich biological glue, especially when combined with VEGF-A and vitamin E | increase | graft survival | human ovarian tissue grafts | - | improves | #7 |
BACKGROUND: Anticancer treatment poses a high risk of ovarian failure. In many cases cryopreservation of ovarian tissue is the only option for fertility preservation. Although autologous transplantation of cryopreserved-thawed ovarian tissue has resulted in live births, slow graft revascularization and ischemia after transplantation leads to substantial follicular loss. Therefore, methods to improve and hasten graft vascularization are needed. The aim of the study was to examine the benefits of host and graft treatments with melatonin, hyaluronan (HA), vascular endothelial growth factor A (VEGF-A) and vitamin E with regard to the outcome of human ovarian tissue grafting. METHODS: Five young cancer patients who underwent laparoscopic ovarian surgery for fertility preservation donated ovarian tissue. Thawed ovarian samples were transplanted into immunodeficient mice divided into seven groups: (A) no treatment; (B) host treatment with melatonin before and after grafting; (C) graft incubation with HA-rich biological glue before transplantation; (D) host as in (B), graft as in (C); (E) host as in (B), graft incubation with VEGF-A and vitamin E; (F) graft as in (C) combined with VEGF-A and vitamin E; (G) host as in (B), graft as in (F). Graft survival was assessed by follicle counts, apoptosis assay and immunohistochemical staining for proliferating cell nuclear antigen and VEGF-A expression. RESULTS: Only grafts implanted in melatonin-treated hosts and grafts incubated with HA-rich biological glue retained their original size. Apoptosis was significantly lower after host treatment with melatonin and graft incubation with HA-rich biological glue plus VEGF-A and vitamin E than in untreated grafts; apoptosis was specifically low in Group G. There were significantly more atretic follicles in the untreated group than in most treated groups. CONCLUSIONS: The findings suggest that host treatment with melatonin or graft incubation with HA-rich biological glue, especially when combined with VEGF-A and vitamin E improves graft survival. This protocol can be applied and holds promise in ovarian autotransplantation for fertility restoration.