1 Virginia Center for Reproductive Medicine, Reston, VA and 2 George Washington University, Washington, DC, 3 Reproductive Medicine Associates of New Jersey, Morristown, NJ, USA
To whom correspondence should be addressed at: 11150 Sunset Hills Road, Suite 100, Reston, VA 20190, USA. E-mail: RScott{at}rmanj.com
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Abstract |
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Key words: ovarian biopsy/ovarian reserve testing
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Introduction |
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The pattern of follicular distribution |
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The recent interest in ovarian tissue cryopreservation for cancer patients has opened the doors for the further investigation of the follicular distribution in the ovarian cortex in young women interested in ovarian cryopreservation before or after chemotherapy. Poirot et al. (2002) collected ovarian tissue from 31 women (seven had half an ovary and 24 had a whole ovary removed), 19 of whom had between three and six courses of chemotherapy (13 had low doses of alkylating agents). They showed that the follicular distribution was again non-homogeneously distributed within the ovarian cortex and that the follicular pool declined with age. It was of interest that the investigators could not find a deleterious effect of prior chemotherapy on the mean follicular concentration (Poirot et al., 2002
).
Most recently, Schmidt et al. (2003) consented 21 women with cancer (six of whom received prior chemotherapy) to have one or both ovaries cryopreserved; 17 had one ovary removed and four had ovarian biopsies. In addition, three of the 21 had both ovaries removed. For the first time, these investigators studied the follicular distribution in the whole ovarian cortex instead of a representative section. Confirming prior results, the investigators showed a significant inverse relationship between age and follicular density. Among the three women who had both ovaries removed, there was a huge variation in the number of primordial follicles between each fragment of the same ovary of several orders of magnitude. In one example, two follicles were found in one fragment and >2000 in another fragment from the same ovary. It was of interest that in all three ovaries, the primordial follicles tended to lie in clusters in the ovarian fragments rather than being evenly distributed throughout the tissue (Schmidt et al., 2003
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Conclusion |
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References |
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