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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

  • Fertility Preservation
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

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.

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Data availability

The data used in this article are available on reasonable request from the corresponding author after granting prespecified criteria for confidential access.

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Funding

This study received no specific dedicated funding.

Author information

Authors and Affiliations

  1. Department of Hematology, Adolescents and Young Adults Unit, Fertility Preservation, APHP, Saint-Louis Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France

    Mitawa Millin Missontsa, Nathalie Dhédin, Virginie Barraud-Lange & Catherine Poirot

  2. Clinique Ngaliema Fertility Center, 42 Avenue Pumbu, Gombe, Kinshasa, Congo

    Mitawa Millin Missontsa

  3. Pediatric Department Sickle Cell Referral Center, Intercommunal Hospital of Créteil, 94000, Creteil, France

    Françoise Bernaudin, Corinne Pondarré, Annie Kamdem & Cécile Arnaud

  4. Department of Obstetrics Gynecology, APHP, Pitié-Salpêtrière-Charles Foix University Hospital, 75013, Paris, France

    Anne Fortin

  5. University Paris XII, Inserm U 955, 94000, Creteil, France

    Corinne Pondarré

  6. Department of Pediatric Immunology and Hematology, APHP, University Paris Cité, Robert Debré Hospital, 75019, Paris, France

    Karima Yakouben, Mony Fahd & Jean-Hugues Dalle

  7. Department of Immuno-Hematology and Pediatric Rheumatology, APHP Center, University Paris Cité, Necker-Enfants Malades Hospital, 75015, Paris, France

    Bénédicte Neven & Martin Castelle

  8. University Paris Cité, 75010, Paris, France

    Bénédicte Neven, Marina Cavazzana, Sabine Sarnacki & Jean-Hugues Dalle

  9. Department of Biotherapy, Necker-Enfants Malades Hospital, 75015, Paris, France

    Marina Cavazzana

  10. Department of Visceral, Urological and Traumatological Surgery, Intercommunal Hospital of Créteil, 9400, Creteil, France

    Harry Lezeau

  11. Department of Pediatric Surgery and Urology, Centre de Référence Des Malformations Rares Des Voies Urinaires (MARVU), ERN eUROGEN Accredited Center, APHP North-Université Paris Cité, Robert-Debré University Hospital, Inserm UMR, 1141 NeuroDev, 75019, Paris, France

    Matthieu Peycelon & Annabel Paye-Jaouen

  12. Department of Obstetrics Gynecology, APHP, University Paris Cité, Lariboisière Hospital, 75010, Paris, France

    Jeremy Sroussi

  13. Division of Pediatric Oncology/Hematology, University Children’s Hospital of Basel, UKBB, Basel, Switzerland

    Tamara Diesch-Furlanetto

  14. Department of Reproductive Biology, APHP Center, University Paris Cité, Cochin Hospital, 75014, Paris, France

    Virginie Barraud-Lange

  15. Department of Visceral and Urological Pediatric Surgery, APHP Center, University Paris Cité, Necker Hospital, 75015, Paris, France

    Sabine Sarnacki

  16. Department of Endocrinology, Intercommunal Hospital of Créteil, 94000, Creteil, France

    Isis Marchand

  17. Department of Obstetrics Gynecology, APHP, University Paris Cité, Robert Debré Hospital, 75019, Paris, France

    Clémence Delcour

  18. Department of Gynecology, APHP, University Paris Cité, Saint-Louis Hospital, 75010, Paris, France

    Dominique Vexiau

  19. Department of Internal Medicine and French Sickle Cell Disease Referral Center, APHP, University Paris Cité, Georges-Pompidou European Hospital, 75015, Paris, France

    Jean-Benoît Arlet

  20. Médecine Sorbonne University, 75005, Paris, France

    Catherine Poirot

Authors
  1. Mitawa Millin Missontsa
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  2. Françoise Bernaudin
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  3. Anne Fortin
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  4. Nathalie Dhédin
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  9. Marina Cavazzana
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  15. Virginie Barraud-Lange
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  17. Mony Fahd
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  22. Annie Kamdem
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  23. Cécile Arnaud
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  24. Jean-Hugues Dalle
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  25. Catherine Poirot
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Contributions

MMM, FB, ND, and CPoi designed the study and contributed to the literature search, data collection, data interpretation, writing, and revision of the manuscript. TDF contributed to the literature search, data collection, and data interpretation. AF, JR, HL, MP, AP-J, and SS were responsible for the ovarian tissue pick-up program. AF performed the ovarian tissue transplantation procedure. VBL was responsible for the ovarian tissue freezing and thawing program. MCav was responsible for Gene Therapy Program. IM, CD, and DV performed the ovarian follow-up. FB, ND, CPon, KY, BN, MCas, MF, JBA, AK, CA, and JHD were responsible for patient recruitment and contributed to the report through discussion. All authors contributed to the revision of the manuscript and agreed to the publication of the manuscript.

Corresponding author

Correspondence to Catherine Poirot.

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Ethics approval and consent to participate

This study was approved by the ethical committee of the Avicenne Hospital, France (CLEA-2022–253). Written informed consent was provided by the patients or parents/participants’ legal guardians.

Competing interests

The authors declare no competing interests.

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Missontsa, M.M., Bernaudin, F., Fortin, A. et al. 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. J Assist Reprod Genet 41, 1027–1034 (2024). https://doi.org/10.1007/s10815-024-03054-4

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