Safeguarding ovarian tissue autotransplantation in cancer patients

Abstract

Autotransplantation of ovarian tissue can be used to

restore fertility in cancer patients following gonadotoxic treatment. Whether

this procedure is safe remains unclear, as current tumor detection methods

(e.g. PCR analysis, immunohistochemistry) render the ovarian tissue unsuitable for transplantation. As a result, the current tumor detection approach includes assessment of only one or two cortical ovarian fragments that are not transplanted, whereas cortical ovarian tissue fragments that are placed back remain unchecked. The studies described in this thesis focused on determining the risk of reintroducing malignant tumor cells following ovarian tissue autotransplantation using the current tumor detection approach, and novel detection methods by which metastatic disease can be detected in the cortical ovarian fragments that are actually transplanted. These novel detection methods include near-infrared fluorescence (NIRF) imaging, a noninvasive imaging technique by which tumor cells can be specifically illuminated using tumor-targeting probes in the near-infrared range (λ = 700-900 nm), and full field optical coherence tomography, an imaging modality that rapidly produces high-resolution histology-like images without the need to fix, freeze, or stain the tissue.

Fertility preservationAutotransplantation of ovarian tissueOvarian metastasesRisk factor analysisNear-infrared fluorescent imagingFull-field optical coherence tomography