Live birth from ovarian grafted tissue after pelvic radiation for rectal cancer.

Autor:	Rozen G; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.; Reproductive Biology Unit, The Royal Women's Hospital, Melbourne, Victoria, Australia., Chander S; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.; Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Polyakov A; Reproductive Biology Unit, The Royal Women's Hospital, Melbourne, Victoria, Australia.; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia., Thevathasan I; Department of Maternal Fetal Medicine, The Royal Women's Hospital, Melbourne, Victoria, Australia., Stern CJ; Reproductive Biology Unit, The Royal Women's Hospital, Melbourne, Victoria, Australia.; Melbourne IVF, East Melbourne, Melbourne, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	F&S reports [F S Rep] 2024 May 01; Vol. 5 (2), pp. 214-218. Date of Electronic Publication: 2024 May 01 (Print Publication: 2024).
DOI:	10.1016/j.xfre.2024.04.004
Abstrakt:	Objective: To study the management of a woman who returned to conceive after high-dose radiation treatment, with documentation of uterine dosimetry, and the efficacy of ovarian tissue grafted into an irradiated pelvis. Design: Case report. Setting: Private and public In Vitro Fertilization units. Patient: A 26-year-old woman underwent radiation treatment for rectal cancer, with half of the uterus and the fundus being exposed to radiation doses of 50 and 25 Gy, respectively. We report the details of the uterine assessment, determining suitability of conception with her own uterus, pregnancy surveillance, and reproductive outcome. Interventions: In Vitro Fertilization stimulation grafted ovarian tissue to assist with pregnancy. Main Outcome Measures: Successful conception and live birth, pregnancy complications and management of high risk pregnancy. Results: The results of magnetic resonance imaging and pelvic ultrasound showed a small uterus with preserved junctional zone anatomy, and although the endometrium was initially thin after high-dose estrogen administration, endometrial thickness increased with time. Twelve grafted ovarian tissue stimulation cycles led to 4 embryo transfers, the last of which resulted in a live birth. She had 2 cervical cerclage procedures because of cervical shortening and delivered a 3.3-kg healthy female neonate at 38 weeks of gestation via lower-segment cesarean section. Conclusions: Successful pregnancy is possible from ovarian tissue grafted into an irradiated pelvis, with high-dose uterine exposure. Careful uterine assessment needs to be undertaken to determine suitability of conception attempt with a patient's own uterus, in consultation with the medical team. Further studies are needed to correlate imaging and biopsy findings with reproductive outcomes. Competing Interests: G.R. has nothing to disclose. S.C. has nothing to disclose. A.P. has nothing to disclose. I.T. has nothing to disclose. C.J.S. has nothing to disclose. (© 2024 Published by Elsevier Inc. on behalf of American Society for Reproductive Medicine.)
Databáze:	MEDLINE
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