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Surgical management of unilateral oophorectomy for ovarian tissue cryopreservation in high-risk children and adolescents with varied backgrounds

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Abstract

Purpose

Fertility preservation (FP) for children is still challenging due to an information gap. In particular, there is little information about the surgical aspects of ovarian tissue cryopreservation (OTC) for children. In the present study, the appropriateness of preoperative management and the criteria of our cases were investigated with the aim of establishing a safe OTC procedure.

Methods

A total of 25 girls who underwent OTC from November 2015 through May 2020 were retrospectively analyzed with IRB approval.

Results

The median age of the patients was 13 (1–17) years. The medical indications were varied (e.g., leukemia, lymphoma, brain tumor), and included rare diseases. Seventeen cases (68%) underwent OTC during chemotherapy or radiotherapy, and 21 (84%) had comorbidities. All cases underwent ovarian tissue retrieval (OTR) with laparoscopy, and the median operating time was 64 (36–97) min, with little bleeding. Although two had complications, all patients started treatment on schedule. The median WBC and CRP increases a day after OTR were 0 (− 4400 to + 5200)/µl and 0.21 (− 0.2 to 0.87) mg/dl, respectively, with no complications.

Conclusion

As long as the preoperative criteria are met, OTC could be possible even for children with a severe blood condition. In such cases, the degrees of the WBC and CRP elevations are useful to assess surgical infection.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Seido Takae, Eriko Shiraishi, Yuriko Iwahata, Hideyuki Iwahata, Shino Sawada, Yuki Suzuki, Yodo Sugishita, Imari Deura, Yuki Horage, Haruhiro Kondo & Nao Suzuki

  2. Department of Pediatric Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Shigeyuki Furuta, Kei Oyama, Yuri Nishiya, Kohei Kawaguchi, Juma Obayashi, Kunihide Tanaka, Hideki Nagae & Hiroaki Kitagawa

  3. Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa, 232-8555, Japan

    Dai Keino

  4. Department of Pediatrics, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 232-8555, Japan

    Dai Keino & Tetsuya Mori

  5. Department of Anesthesiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Miki Sakamoto

Authors
  1. Seido Takae
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  2. Shigeyuki Furuta
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  3. Dai Keino
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  5. Yuriko Iwahata
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  6. Kei Oyama
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  7. Hideyuki Iwahata
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  8. Yuri Nishiya
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  9. Kohei Kawaguchi
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  10. Juma Obayashi
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  11. Kunihide Tanaka
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  12. Shino Sawada
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  13. Yuki Suzuki
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  14. Yodo Sugishita
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  15. Imari Deura
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  16. Yuki Horage
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  17. Hideki Nagae
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  18. Haruhiro Kondo
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  19. Miki Sakamoto
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  20. Tetsuya Mori
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  21. Hiroaki Kitagawa
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  22. Nao Suzuki
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Contributions

All authors contributed to the study conception and design. Material preparation and data or writing materials collection were performed by ES, YI, KO, HI, YN, KK, JO, KT, SS, YS, YS, YH, HN, HK, and ID. Data analysis was performed by ST, SF and DK. The first draft of the manuscript was written by ST, and all authors commented on the original versions of the manuscript. In particular, critical discussion of each specialist aspect was performed by ST, SF, MS, TM, HK, and NS. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nao Suzuki.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Research involving human participants and/or animals

The present clinical study was performed with the approval of the IRB of St. Marianna University School of Medicine, as “The verification of safety and efficacy of ovarian tissue and oocyte cryopreservation for child patients” (IRB approval number: No. 3424). The study was also registered with the UMIN Clinical Trials Registry (URL: https://www.umin.ac.jp/ctr).

Informed consent

As mentioned in the manuscript, all legal guardians and patients (16 years and above) gave written, informed consent in keeping with the Declaration of Helsinki, and the study was approved by the institutional review board of the university. Patients under 16 years of age provided their informed consent after reproductive surgeons and pediatricians provided information through illustrations and animation.

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Takae, S., Furuta, S., Keino, D. et al. Surgical management of unilateral oophorectomy for ovarian tissue cryopreservation in high-risk children and adolescents with varied backgrounds. Pediatr Surg Int 37, 1021–1029 (2021). https://doi.org/10.1007/s00383-021-04900-7

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  • DOI: https://doi.org/10.1007/s00383-021-04900-7

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