Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years

Meryam El Issaoui; Veronica Giorgine; Linn S. Mamsen; Catherine Rechnitzer; Niels Birkebæk; Niels Clausen; Thomas William Kelsey; Claus Yding Andersen

doi:10.1016/j.fertnstert.2016.09.001

Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years

Meryam El Issaoui, Veronica Giorgine, Linn S. Mamsen, Catherine Rechnitzer, Niels Birkebæk, Niels Clausen, Thomas William Kelsey, Claus Yding Andersen

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To study the impact of first-line antineoplastic treatment on the ovarian reserve in young girls returning for ovarian tissue cryopreservation (OTC) in connection with a relapse.
Design: Retrospective case-control study.
Setting: University hospitals.
Patients: Sixty-three girls under the age of 18 years who underwent OTC before (group 1: 31 patients) and after (group 2: 32 patients) their initial cancer treatment.
Intervention(s): None.
Main Outcome Measure(s): Follicular densities (follicles/mm³) measured from an ovarian cortical biopsy before OTC. The ovarian volume (mL) of entire ovaries excised for OTC was also monitored.
Result(s):There was no statistically significant difference in the mean age or follicular density between groups 1 and 2 (334 ± 476/mm³ vs. 327 ± 756/mm³). In contrast, the ovarian volume and total number of ovarian cortex chips cryopreserved were statistically significantly lower in patients who received gonadotoxic treatment before OTC (mean ± standard deviation [SD]: ovarian volume, 5.3 ± 3.1 mL vs. 2.9 ± 2.1 mL, respectively; number of cortex chips: 21.3 ± 8.1 vs. 15.2 ± 7.1, respectively). The reduction in the estimated ovarian reserve ranged from 10% to 20% in children to around 30% in adolescent girls (>10 years).
Conclusion(s): Girls under the age of 10 tolerate a gonadotoxic insult better than adolescents, who may experience up to a 30% reduction in the ovarian reserve via first-line gonadotoxic treatment, which at present is considered to have little effect on the follicle pool. This information will improve counseling of young female cancer patients in deciding whether to undergo fertility preservation treatment.

Original language	English
Pages (from-to)	1757–1762.e1
Journal	Fertility and Sterility
Volume	106
Issue number	7
Early online date	4 Oct 2016
DOIs	https://doi.org/10.1016/j.fertnstert.2016.09.001
Publication status	Published - Dec 2016

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Ovarian tissue cryopreservation
Fertility preservation
Ovarian volume
Follicle density

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10.1016/j.fertnstert.2016.09.001

ElIssaoui_2016_Firstline_FertilitySterility_AAM
© 2016, American Society for Reproductive Medicine. This work is made available online in accordance with the publisher’s policies. This is the author created, accepted version manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at www.fertstert.org / http://dx.doi.org/10.1016/j.fertnstert.2016.09.002
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http://www.fertstert.org/article/S0015-0282(16)62791-7/fulltext

Cite this

@article{60eea16f6f804a5fa931f202da93aa13,

title = "Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years",

abstract = "Objective: To study the impact of first-line antineoplastic treatment on the ovarian reserve in young girls returning for ovarian tissue cryopreservation (OTC) in connection with a relapse. Design: Retrospective case-control study. Setting: University hospitals. Patients: Sixty-three girls under the age of 18 years who underwent OTC before (group 1: 31 patients) and after (group 2: 32 patients) their initial cancer treatment. Intervention(s): None. Main Outcome Measure(s): Follicular densities (follicles/mm3) measured from an ovarian cortical biopsy before OTC. The ovarian volume (mL) of entire ovaries excised for OTC was also monitored. Result(s):There was no statistically significant difference in the mean age or follicular density between groups 1 and 2 (334 ± 476/mm3 vs. 327 ± 756/mm3). In contrast, the ovarian volume and total number of ovarian cortex chips cryopreserved were statistically significantly lower in patients who received gonadotoxic treatment before OTC (mean ± standard deviation [SD]: ovarian volume, 5.3 ± 3.1 mL vs. 2.9 ± 2.1 mL, respectively; number of cortex chips: 21.3 ± 8.1 vs. 15.2 ± 7.1, respectively). The reduction in the estimated ovarian reserve ranged from 10\% to 20\% in children to around 30\% in adolescent girls (>10 years). Conclusion(s): Girls under the age of 10 tolerate a gonadotoxic insult better than adolescents, who may experience up to a 30\% reduction in the ovarian reserve via first-line gonadotoxic treatment, which at present is considered to have little effect on the follicle pool. This information will improve counseling of young female cancer patients in deciding whether to undergo fertility preservation treatment.",

keywords = "Ovarian tissue cryopreservation, Fertility preservation, Ovarian volume, Follicle density",

author = "\{El Issaoui\}, Meryam and Veronica Giorgine and Mamsen, \{Linn S.\} and Catherine Rechnitzer and Niels Birkeb{\ae}k and Niels Clausen and Kelsey, \{Thomas William\} and Andersen, \{Claus Yding\}",

note = "The Child Cancer Foundation in Denmark, The Novo Nordisk Foundation and the EU interregional project ReproHigh/ReproUnion are thanked for having funded this study. ",

year = "2016",

month = dec,

doi = "10.1016/j.fertnstert.2016.09.001",

language = "English",

volume = "106",

pages = "1757–1762.e1",

journal = "Fertility and Sterility",

issn = "0015-0282",

publisher = "Elsevier Inc.",

number = "7",

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TY - JOUR

T1 - Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years

AU - El Issaoui, Meryam

AU - Giorgine, Veronica

AU - Mamsen, Linn S.

AU - Rechnitzer, Catherine

AU - Birkebæk, Niels

AU - Clausen, Niels

AU - Kelsey, Thomas William

AU - Andersen, Claus Yding

N1 - The Child Cancer Foundation in Denmark, The Novo Nordisk Foundation and the EU interregional project ReproHigh/ReproUnion are thanked for having funded this study.

PY - 2016/12

Y1 - 2016/12

N2 - Objective: To study the impact of first-line antineoplastic treatment on the ovarian reserve in young girls returning for ovarian tissue cryopreservation (OTC) in connection with a relapse. Design: Retrospective case-control study. Setting: University hospitals. Patients: Sixty-three girls under the age of 18 years who underwent OTC before (group 1: 31 patients) and after (group 2: 32 patients) their initial cancer treatment. Intervention(s): None. Main Outcome Measure(s): Follicular densities (follicles/mm3) measured from an ovarian cortical biopsy before OTC. The ovarian volume (mL) of entire ovaries excised for OTC was also monitored. Result(s):There was no statistically significant difference in the mean age or follicular density between groups 1 and 2 (334 ± 476/mm3 vs. 327 ± 756/mm3). In contrast, the ovarian volume and total number of ovarian cortex chips cryopreserved were statistically significantly lower in patients who received gonadotoxic treatment before OTC (mean ± standard deviation [SD]: ovarian volume, 5.3 ± 3.1 mL vs. 2.9 ± 2.1 mL, respectively; number of cortex chips: 21.3 ± 8.1 vs. 15.2 ± 7.1, respectively). The reduction in the estimated ovarian reserve ranged from 10% to 20% in children to around 30% in adolescent girls (>10 years). Conclusion(s): Girls under the age of 10 tolerate a gonadotoxic insult better than adolescents, who may experience up to a 30% reduction in the ovarian reserve via first-line gonadotoxic treatment, which at present is considered to have little effect on the follicle pool. This information will improve counseling of young female cancer patients in deciding whether to undergo fertility preservation treatment.

AB - Objective: To study the impact of first-line antineoplastic treatment on the ovarian reserve in young girls returning for ovarian tissue cryopreservation (OTC) in connection with a relapse. Design: Retrospective case-control study. Setting: University hospitals. Patients: Sixty-three girls under the age of 18 years who underwent OTC before (group 1: 31 patients) and after (group 2: 32 patients) their initial cancer treatment. Intervention(s): None. Main Outcome Measure(s): Follicular densities (follicles/mm3) measured from an ovarian cortical biopsy before OTC. The ovarian volume (mL) of entire ovaries excised for OTC was also monitored. Result(s):There was no statistically significant difference in the mean age or follicular density between groups 1 and 2 (334 ± 476/mm3 vs. 327 ± 756/mm3). In contrast, the ovarian volume and total number of ovarian cortex chips cryopreserved were statistically significantly lower in patients who received gonadotoxic treatment before OTC (mean ± standard deviation [SD]: ovarian volume, 5.3 ± 3.1 mL vs. 2.9 ± 2.1 mL, respectively; number of cortex chips: 21.3 ± 8.1 vs. 15.2 ± 7.1, respectively). The reduction in the estimated ovarian reserve ranged from 10% to 20% in children to around 30% in adolescent girls (>10 years). Conclusion(s): Girls under the age of 10 tolerate a gonadotoxic insult better than adolescents, who may experience up to a 30% reduction in the ovarian reserve via first-line gonadotoxic treatment, which at present is considered to have little effect on the follicle pool. This information will improve counseling of young female cancer patients in deciding whether to undergo fertility preservation treatment.

KW - Ovarian tissue cryopreservation

KW - Fertility preservation

KW - Ovarian volume

KW - Follicle density

UR - https://www.scopus.com/pages/publications/84998886459

U2 - 10.1016/j.fertnstert.2016.09.001

DO - 10.1016/j.fertnstert.2016.09.001

M3 - Article

SN - 0015-0282

VL - 106

SP - 1757–1762.e1

JO - Fertility and Sterility

JF - Fertility and Sterility

IS - 7

ER -

Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years

Abstract

UN SDGs

Keywords

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Effect of First Line Cancer Treatment on the Ovarian Reserve and Follicular Density in Girls under the Age of 18 Years

Fertility preservation in pre-pubertal girls with cancer: the role of ovarian tissue cryopreservation

An externally validated age-related model of mean follicle density in the cortex of the human ovary

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