| Background:Female cancer patients may lose fertility after cancer-related treatment. Women anticipating hematopoietic stem cell transplantation for the treatment of benign diseases or at high risk of premature ovarian failure, may also need fertility preservation. Embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation can all preserve fertility. Compared with embryo cryopreservation, which is the only established method of fertility preservation, ovarian tissue cryopreservation is still experimental. Vitrification and slow freezing are two main methods, and currently reported live births of frozen-thawed ovarian tissue transplantation were all using the latter. Vitrification was superior than slow freezing in embryo cryopreservation since it is more convenient and less time-consuming. However, the effect of vitrification in ovarian tissue cryopreservation is still controversial. Carrier selection may play an important role. The cell strainer is used for cell dispersion and filter in cell culture. It mainly made of polypropylene and ethylene, with a pore size of 100 μm. Cryoprotectants and liquid nitrogen can quickly penetrate, thus we assume cell strainers could be promising carriers of vitrification.Objective:Compare the cryopreservation effect of human ovarian tissue between vitrification with a cell strainer as the carrier and slow programming freezing procedures.Method:Human ovarian tissue was retrieved from 4 women underwent oophorectomy. After processing, the ovarian cortex was randomly assigned to three groups:fresh group(F) as a control, slow freezing group(S) and vitrification group(V). The cell strainer was applied as a carrier of vitrification. After thawing, tissue was fixed for histological analysis, apoptosis analysis using TUNEL assay and IGF1-R expression using imunohistochemistry. Besides, thawed tissue was cultured in vitro and xenotransplanted in castrated female nude mice, estradiol(E2) from the medium and serum was tested. Relative results were compared among three groups.Results:Morphologically normal primordial follicles were comparable between the fresh group and vitrification group, while that of slow freezing group was significantly decreased (P<0.001)). Morphologically normal primary follicles were similar between the slow freezing group and vitrification group, but both were lower than that of the fresh group (P<0.05). The apoptosis rate was similar among the three groups (P>0.05). Staining for IGF1-R can be observed in granulosa cells of primordial follicles and primary follicles of all three groups. The staining pattern of IGF1-R was similar among three groups(P>0.05). After culturing in vitro for 2 weeks, the concentration of E2 continued to rise. E2 of the fresh group was significantly higher than slow freezing group and vitrification group(P<0.001), but E2 of the latter two groups were comparable(P>0.05). The serum E2 of group V and group S was significantly higher than the castrated female nude mice.Conclusion:Both slow freezing and vitification with cell strainers as carriers were effective in human ovarian tissue cryopreservation, and the latter was superior in preserving primordial follicles. After thawed and cultured in vitro and xenotransplanted, these tissue could secret E2. Staining for IGF1-R can be observed in granulosa cells of primordial follicles and primary follicles. Cryopreservation may not significantly alter the immuno-activity of IGF1-R.Objective:To observe the bleeding pattern change and side effects of a single-rod, subdermal, progestin-only,long-acting, and reversible contraceptive implant-Implanon.Method:A total of 45 healthy women were included and inserted Implanon after informed consent was sighed-Taking 90-day as a period,we followed these subjects for four periods about their bleeding pattern,dysmenorrhoea, weight change,acne and other side effects.Results:There were no pregnancies during this study. In the end of the first 90 days, the average number of bleeding/spotting days and bleeding/spotting episodes was 28.2 and 3.2 separately. Bleeding patterns were observed as follows:frequent and/or prolonged bleeding(40%), infrequent(35.6%), normal frequency(35.6%) and amenorrhoea (11.1%). However,in the end of the 4th period, the average number of bleeding/spotting days bleeding/spotting episodes decreased to 17.3 and 2.3 separately. Frequent and/or prolonged bleeding was decresed sharply(11.1%).Infrequent (41.7%),normal frequency(38.9%) and amenorrhoea (13.9%) were observed in most people. After one year observation, Most women (82.4%) who reported baseline dysmenorrhoea experienced complete resolution or relief of symptoms. Subjects experienced a significant weight gain compared with baseline(P<0.01),with the average number is 2.5 kg. Other side effects include acne(n=1),mood fluctuation(n=2)and drowsiness.(n=1)Conclusion:The contraceptive efficacy was satisfied with Implanon. However,Implanon was associated with an unpredictable bleeding pattern, which includes amenorrhoea and infrequent, frequent, and/or prolonged bleeding. The unpleasant bleeding pattern will improve with extended use. Implanon is effective in alleviating dysmenorrhoea, and may induce weight gain. The incidence of other side effects was rather low. |
PDF Full Text Request