Oncofertilidad femenina: estrategias actuales y futuras
Revista SAEGRE
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Palabras clave

oncofertilidad
criopreservacion
tejido ovarico
maduracion in vitro
ovario artificial trasplantable

Cómo citar

1.
Vitale F. Oncofertilidad femenina: estrategias actuales y futuras. RSAEGRE [Internet]. 22 de julio de 2024 [citado 10 de octubre de 2024];31(2):14-22. Disponible en: http://revistasaegre.com.ar/index.php/revista/article/view/28

Resumen

En las ultimas décadas, los avances en diagnóstico y tratamiento de enfermedades oncológicas han aumentado la supervivencia de los pacientes, generando como daño colateral altas tasas de insuficiencia ovárica prematura (IOP) e infertilidad, principalmente en pacientes jóvenes, debido a la gonadotoxicidad de la quimioterapia y la radioterapia. Este artículo revisa en primera instancia las distintas estrategias actuales de preservación de la fertilidad en este grupo de pacientes, como la criopreservación de embriones/ovocitos, que se presenta como opción convencional establecida, con altas tasas de éxito. Nuevos protocolos, como el inicio aleatorio de la estimulación ovárica, han mejorado la eficiencia y reducido el tiempo de espera para iniciar el tratamiento oncológico. La criopreservación y el trasplante de tejido ovárico (CTO/TTO) es la única opción válida para niñas prepuberales, y para casos urgentes. Estudios recientes muestran favorables tasas de éxito en la restauración endocrina y de la fertilidad, aunque todavia persisten preocupaciones sobre la reintroducción de células malignas. La maduración in vitro (MIV) de ovocitos ofrece una alternativa para pacientes con contraindicaciones para la estimulación ovárica controlada. Aunque la tasa de éxito ha mejorado, sigue siendo inferior a la de ovocitos maduros obtenidos mediante estimulación ovárica convencional. La revisión también plantea futuras estrategias de oncofertilidad que por el momento se encuentran en fase experimental, como el uso de nuevos agentes ferto-protectores durante la administración de quimioterapia, el cultivo de tejido ovárico para el desarrollo folicular in vitro y la aplicabilidad de ovarios artificiales trasplantables.

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Citas

Trama A, Bernasconi A, McCabe MG, Guevara M, Gatta G, Botta L, et al. Is the cancer survival improvement in European and American adolescent and young adults still lagging behind that in children? Pediatric Blood & Cancer. 2019 Jan;66(1):e27407.

Donnez J, Dolmans MM. Fertility Preservation in Women. Campion EW, editor. N Engl J Med. 2017 Oct 26;377(17):1657–65.

Wallace WHB, Kelsey TW. Human Ovarian Reserve from Conception to the Menopause. Vitzthum VJ, editor. PLoS ONE. 2010 Jan 27;5(1):e8772.

Pampanini V, Hassan J, Oliver E, Stukenborg JB, Damdimopoulou P, Jahnukainen K. Fertility Preservation for Prepubertal Patients at Risk of Infertility: Present Status and Future Perspectives. Horm Res Paediatr. 2020;93(11–12):599–608.

Sun B, Yeh J. Onco-fertility and personalized testing for potential for loss of ovarian reserve in patients undergoing chemotherapy: proposed next steps for development of genetic testing to predict changes in ovarian reserve. Fertil Res and Pract. 2021 Dec;7(1):13.

Spears N, Lopes F, Stefansdottir A, Rossi V, De Felici M, Anderson RA, et al. Ovarian damage from chemotherapy and current approaches to its protection. Human Reproduction Update. 2019 Nov 5;25(6):673–93.

Szymanska KJ, Tan X, Oktay K. Unraveling the mechanisms of chemotherapy-induced damage to human primordial follicle reserve: road to developing therapeutics for fertility preservation and reversing ovarian aging. Molecular Human Reproduction. 2020 Aug 1;26(8):553–66.

Bedoschi G, Navarro PA, Oktay K. Chemotherapy-induced damage to ovary: mechanisms and clinical impact. Future Oncology. 2016 Oct;12(20):2333–44.

Wallace WHB, Thomson AB, Saran F, Kelsey TW. Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys. 2005 Jul 1;62(3):738–44.

Meirow D, Biederman H, Anderson RA, Wallace WHB. Toxicity of chemotherapy and radiation on female reproduction. Clin Obstet Gynecol. 2010 Dec;53(4):727–39.

Rovani BT, Rissi VB, Rovani MT, Gasperin BG, Baumhardt T, Bordignon V, et al. Analysis of nuclear maturation, DNA damage and repair gene expression of bovine oocyte and cumulus cells submitted to ionizing radiation. Anim Reprod. 2023;20(2):e20230021.

ESHRE Guideline Group on Female Fertility Preservation, Anderson RA, Amant F, Braat D, D’Angelo A, Chuva de Sousa Lopes SM, et al. ESHRE guideline: female fertility preservation. Hum Reprod Open. 2020;2020(4):hoaa052.

Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013 Jan;99(1):37–43.

Yasmin E, Mitchell R, Lane S. Preservation of fertility in teenagers and young adults treated for haematological malignancies. Lancet Haematol. 2021 Feb;8(2):e149–60.

Cobo A, Coello A, Hassane M, Remohí J. Oocyte and Embryo Cryopreservation: Methodology and Clinical Results. In: Grynberg M, Patrizio P, editors. Female and Male Fertility Preservation [Internet]. Cham: Springer International Publishing; 2022 [cited 2024 Mar 4]. p. 97–118. Available from: https://link.springer.com/10.1007/978-3-030-47767-7_8

Cakmak H, Rosen MP. Random-start ovarian stimulation in patients with cancer. Current Opinion in Obstetrics & Gynecology. 2015 Jun;27(3):215–21.

Cavagna F, Pontes A, Cavagna M, Dzik A, Donadio NF, Portela R, et al. Specific Protocols of Controlled Ovarian Stimulation for Oocyte Cryopreservation in Breast Cancer Patients. Current Oncology. 2018 Dec 1;25(6):527–32.

Polat M, Mumusoglu S, Yarali Ozbek I, Bozdag G, Yarali H. Double or dual stimulation in poor ovarian responders: where do we stand? Clin Med Insights Reprod Health. 2021 Jan;15:263349412110241.

Vaiarelli A, Cimadomo D, Trabucco E, Vallefuoco R, Buffo L, Dusi L, et al. Double Stimulation in the Same Ovarian Cycle (DuoStim) to Maximize the Number of Oocytes Retrieved From Poor Prognosis Patients: A Multicenter Experience and SWOT Analysis. Front Endocrinol (Lausanne). 2018;9:317.

Bonardi B, Massarotti C, Bruzzone M, Goldrat O, Mangili G, Anserini P, et al. Efficacy and Safety of Controlled Ovarian Stimulation With or Without Letrozole Co-administration for Fertility Preservation: A Systematic Review and Meta-Analysis. Front Oncol. 2020;10:574669.

Kim J, Turan V, Oktay K. Long-Term Safety of Letrozole and Gonadotropin Stimulation for Fertility Preservation in Women With Breast Cancer. The Journal of Clinical Endocrinology & Metabolism. 2016 Apr;101(4):1364–71.

Chan JL, Johnson LNC, Efymow BL, Sammel MD, Gracia CR. Outcomes of ovarian stimulation after treatment with chemotherapy. J Assist Reprod Genet. 2015 Oct;32(10):1537–45.

Wallace WHB, Kelsey TW, Anderson RA. Fertility preservation in pre-pubertal girls with cancer: the role of ovarian tissue cryopreservation. Fertility and Sterility. 2016 Jan;105(1):6–12.

Donnez J, Silber S, Andersen CY, Demeestere I, Piver P, Meirow D, et al. Children born after autotransplantation of cryopreserved ovarian tissue. A review of 13 live births. Annals of Medicine. 2011 Sep;43(6):437–50.

Dolmans MM, von Wolff M, Poirot C, Diaz-Garcia C, Cacciottola L, Boissel N, et al. Transplantation of cryopreserved ovarian tissue in a series of 285 women: a review of five leading European centers. Fertil Steril. 2021b;115(5):1102–15.

Isachenko V, Isachenko E, Kreienberg R, Woriedh M, Weiss J. Human ovarian tissue cryopreservation: quality of follicles as a criteria of effectiveness. Reproductive BioMedicine Online. 2010 Apr;20(4):441–2.

Suzuki N, Yoshioka N, Takae S, Sugishita Y, Tamura M, Hashimoto S, et al. Successful fertility preservation following ovarian tissue vitrification in patients with primary ovarian insufficiency. Hum Reprod. 2015 Mar;30(3):608–15.

Behl S, Joshi VB, Larson NB, Young MC, Bilal M, Walker DL, et al. Vitrification versus slow freezing of human ovarian tissue: a systematic review and meta-analysis of histological outcomes. J Assist Reprod Genet. 2023 Mar;40(3):455–64.

Roness H, Meirow D. FERTILITY PRESERVATION: Follicle reserve loss in ovarian tissue transplantation. Reproduction. 2019 Nov;158(5):F35–44.

Manavella DD, Cacciottola L, Pommé S, Desmet CM, Jordan BF, Donnez J, et al. Two-step transplantation with adipose tissue-derived stem cells increases follicle survival by enhancing vascularization in xenografted frozen–thawed human ovarian tissue. Human Reproduction. 2018 Jun 1;33(6):1107–16.

Gao J, Huang Y, Li M, Zhao H, Zhao Y, Li R, et al. Effect of Local Basic Fibroblast Growth Factor and Vascular Endothelial Growth Factor on Subcutaneously Allotransplanted Ovarian Tissue in Ovariectomized Mice. Zhang M, editor. PLoS ONE. 2015 Jul 24;10(7):e0134035.

Cacciottola L, Courtoy GE, Nguyen TYT, Hossay C, Donnez J, Dolmans MM. Adipose tissue-derived stem cells protect the primordial follicle pool from both direct follicle death and abnormal activation after ovarian tissue transplantation. J Assist Reprod Genet. 2021 Jan;38(1):151–61.

Dolmans MM, Marinescu C, Saussoy P, Van Langendonckt A, Amorim C, Donnez J. Reimplantation of cryopreserved ovarian tissue from patients with acute lymphoblastic leukemia is potentially unsafe. Blood. 2010 Oct 21;116(16):2908–14.

Donnez J, Manavella DD, Dolmans MM. Techniques for ovarian tissue transplantation and results. Minerva Ginecol. 2018 Aug;70(4):424–31.

Chian RC, Uzelac PS, Nargund G. In vitro maturation of human immature oocytes for fertility preservation. Fertil Steril. 2013 Apr;99(5):1173–81.

Mostinckx L, Segers I, Belva F, Buyl R, Santos-Ribeiro S, Blockeel C, et al. Obstetric and neonatal outcome of ART in patients with polycystic ovary syndrome: IVM of oocytes versus controlled ovarian stimulation. Hum Reprod. 2019 Aug 1;34(8):1595–607.

Mostinckx L, Goyens E, Mackens S, Roelens C, Boudry L, Uvin V, et al. Clinical outcomes from ART in predicted hyperresponders: in vitro maturation of oocytes versus conventional ovarian stimulation for IVF/ICSI. Hum Reprod. 2024 Jan 4;dead273.

Vuong LN, Ho VNA, Ho TM, Dang VQ, Phung TH, Giang NH, et al. In-vitro maturation of oocytes versus conventional IVF in women with infertility and a high antral follicle count: a randomized non-inferiority controlled trial. Human Reproduction. 2020 Nov 1;35(11):2537–47.

Walls ML, Ryan JP, Keelan JA, Hart R. In vitro maturation is associated with increased early embryo arrest without impairing morphokinetic development of useable embryos progressing to blastocysts. Hum Reprod. 2015 Aug;30(8):1842–9.

Moawad NS, Santamaria E, Rhoton-Vlasak A, Lightsey JL. Laparoscopic Ovarian Transposition Before Pelvic Cancer Treatment: Ovarian Function and Fertility Preservation. Journal of Minimally Invasive Gynecology. 2017 Jan;24(1):28–35.

Tessier L, McKechnie T, Lee Y, Park LJ, Gangam N, Eskicioglu C. Laparoscopic ovarian transposition prior to pelvic radiation in young women with anorectal malignancies: a systematic review and meta-analysis of prevalence. Colorectal Disease. 2023 Jul;25(7):1336–48.

Genovese F, Zambrotta E, Incognito GG, Gulino FA, Di Guardo F, Genovese D, et al. Techniques and endocrine-reproductive outcomes of ovarian transposition prior to pelvic radiotherapy in both gynecologic and non-gynecologic cancers: A systematic review and meta-analysis. Intl J Gynecology & Obste. 2023 Nov 8;ijgo.15229.

Sonmezer M. Fertility preservation in female patients. HumanReproduction Update. 2004 May 1;10(3):251–66.

Buonomo B, Orecchia R, Tomao F, Pup LD, Garcia-Faura A,Peccatori FA. Uterine irradiation as a determinant of infertility and pregnancy losses in young cancer survivors. Ecancermedicalscience. 2020;14:1032.

Mauri D, Gazouli I, Zarkavelis G, Papadaki A, Mavroeidis L, Gkoura S, et al. Chemotherapy Associated Ovarian Failure. Front Endocrinol (Lausanne). 2020;11:572388.

Blumenfeld Z, Zur H, Dann EJ. Gonadotropin-Releasing Hormone Agonist Cotreatment During Chemotherapy May

Increase Pregnancy Rate in Survivors. Oncologist. 2015 Nov;20(11):1283–9.

Dolmans MM, Taylor HS, Rodriguez-Wallberg KA, Blumenfeld Z, Lambertini M, von Wolff M, et al. Utility of gonadotropin-releasing hormone agonists for fertility preservation in women receiving chemotherapy: pros and cons. Fertility and Sterility. 2020 Oct;114(4):725–38.

Lambertini M, Moore HCF, Leonard RCF, Loibl S, Munster P, Bruzzone M, et al. Gonadotropin-Releasing Hormone Agonists During Chemotherapy for Preservation of Ovarian Function and Fertility in Premenopausal Patients With Early Breast Cancer: A Systematic Review and Meta-Analysis of Individual Patient–Level Data. JCO. 2018 Jul 1;36(19):1981–90.

Leonard RCF, Adamson DJA, Bertelli G, Mansi J, Yellowlees A, Dunlop J, et al. GnRH agonist for protection against ovarian toxicity during chemotherapy for early breast cancer: the Anglo Celtic Group OPTION trial. Annals of Oncology. 2017 Aug;28(8):1811–6.

Oktay K, Harvey BE, Partridge AH, Quinn GP, Reinecke J, Taylor HS, et al. Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update. JCO. 2018 Jul 1;36(19):1994–2001.

Lambertini M, Peccatori FA, Demeestere I, Amant F, Wyns C, Stukenborg JB, et al. Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO Clinical Practice Guidelines†. Annals of Oncology. 2020 Dec;31(12):1664–78.

Devos M, Diaz Vidal P, Bouziotis J, Anckaert E, Dolmans MM, Demeestere I. Impact of first chemotherapy exposure on follicle activation and survival in human cryopreserved ovarian tissue. Human Reproduction. 2023 Mar 1;38(3):408–20.

Zhou L, Xie Y, Li S, Liang Y, Qiu Q, Lin H, et al. Rapamycin Prevents cyclophosphamide-induced Over-activation of Primordial Follicle pool through PI3K/Akt/mTOR Signaling Pathway in vivo. J Ovarian Res. 2017 Dec;10(1):56.

Xie Y, Li S, Zhou L, Lin H, Jiao X, Qiu Q, et al. Rapamycin preserves the primordial follicle pool during cisplatin treatment in vitro and in vivo. Molecular Reproduction Devel. 2020 Apr;87(4):442–53.

Steelman LS, Chappell WH, Abrams SL, Kempf CR, Long J, Laidler P, et al. Roles of the Raf/MEK/ERK and PI3K/PTEN/Akt/mTOR pathways in controlling growth and sensitivity to therapy-implications for cancer and aging. Aging. 2011 Mar 10;3(3):192–222.

Kano M, Sosulski AE, Zhang L, Saatcioglu HD, Wang D, Nagykery N, et al. AMH/MIS as a contraceptive that protects the ovarian reserve during chemotherapy. Proc Natl Acad Sci USA [Internet]. 2017 Feb 28 [cited 2024 Mar 6];114(9). Available from: https://pnas.org/doi/full/10.1073/pnas.1620729114

Roness H, Spector I, Leichtmann-Bardoogo Y, Savino AM, Dereh-Haim S, Meirow D. Pharmacological administration of recombinant human AMH rescues ovarian reserve and preserves fertility in a mouse model of chemotherapy, without interfering with anti-tumoural effects. J Assist Reprod Genet. 2019 Sep;36(9):1793–803.

McLaughlin M, Albertini DF, Wallace WHB, Anderson RA, Telfer EE. Metaphase II oocytes from human unilaminar follicles grown in a multi-step culture system. Mol Hum Reprod. 2018 Mar 1;24(3):135–42.

Dadashzadeh A, Moghassemi S, Peaucelle A, Lucci CM, Amorim CA. Mind the mechanical strength: tailoring a 3D matrix to encapsulate isolated human preantral follicles. Hum Reprod Open. 2023;2023(2):hoad004.

Dolmans MM, Martinez-Madrid B, Gadisseux E, Guiot Y, Yuan WY, Torre A, et al. Short-term transplantation of isolated human ovarian follicles and cortical tissue into nude mice. Reproduction. 2007 Aug;134(2):253–62.

Paulini F, Vilela JMV, Chiti MC, Donnez J, Jadoul P, Dolmans

MM, et al. Survival and growth of human preantral follicles after cryopreservation of ovarian tissue, follicle isolation and short-term xenografting. Reproductive BioMedicine Online. 2016 Sep;33(3):425–32.

Dolmans MM, Yuan WY, Camboni A, Torre A, Langendonckt AV, Martinez-Madrid B, et al. Development of antral follicles after xenografting of isolated small human preantral follicles. Reproductive BioMedicine Online. 2008 Jan;16(5):705–11.

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