Jacques Donnez

Chemo- or radiotherapy can induce premature ovarian failure (POF), and ovarian tissue cryopreservation and transplantation may be proposed to restore ovarian function. Our aim was to evaluate the quality of oocytes and embryos derived from frozen-thawed transplanted ovarian tissue. Women were 21–28 years old at tissue cryopreservation. Nine women suffering POF following chemotherapy with or without radiotherapy underwent orthotopic ovarian tissue transplantation. After 12 months of spontaneous cycles without pregnancy, oocyte retrieval was performed in four patients during mildly stimulated or spontaneous cycles. ICSI was performed in all cases, with embryo transfer on day 3. Light and electron microscopy was used to study oocytes and embryos. Signs of ovarian function restoration (estradiol peak, decreased FSH, follicular development) began 16–26 weeks after reimplantation. Twenty-one oocyte retrieval attempts were made. At least one oocyte was collected in 15 cases, giving an empty follicle rate per retrieval of 29% (6/21). Sixteen oocytes were recovered, of which 6 were abnormal or immature (38%) and 10 (62%) were in metaphase II (MII). Three MII oocytes failed to fertilize, two showed abnormal fertilization and five normal MII oocytes successfully fertilized with subsequent normal embryo development (Grade 2), yielding an embryo transfer rate of 24% per retrieval. No pregnancy occurred. IVF in women with orthotopically grafted frozen-thawed ovarian tissue involves a higher risk of empty follicles, abnormal or immature oocytes, and low embryo transfer rates.

Purpose: Ectopic endometrial tissue is biochemically and functionally distinct from eutopic endometrium, including differences in receptivity to steroids and invasive potential. For this reason, using ectopic endometrial tissue to induce endometriosis in animal models may be of interest to understand better the pathogenesis of this disease. The aim of this study was to evaluate the potential of human pelvic endometriotic lesions (specifically red lesions) to implant into the peritoneal cavity of nude mice. Methods: Human peritoneal endometriotic tissue (red lesions) was injected into the pelvic cavity of nude mice. The mice were euthanized after 5 or 14 days, lesions were recovered, and histological analysis was performed. Proliferative activity and neoangiogenesis of lesions were assessed after Ki67 and CD34 immunohistological staining, respectively. Results: After 5 and 14 days, endometriotic tissue was found to have implanted onto intact mesothelium and reorganized into structured glands and stroma, forming endometriosis-like lesions. These lesions showed considerable proliferative activity and effective neoangiogenesis. Conclusion: This model represents a promising tool to study in vivo implantation of human ectopic endometrium, which is dissimilar to eutopic endometrium. Moreover, this study shows that glands and stroma detached from red endometriotic lesions are able to implant in other peritoneal sites, as in a metastatic process.

The aim of this study is to review the current literature associating endometriosis with iron and to discuss the potential causes and consequences of iron overload in the pelvic cavity. Indeed, iron is essential for all living organisms. However, excess iron can result in toxicity and is associated with pathological disorders. In endometriosis patients, iron overload has been demonstrated in the different components of the peritoneal cavity (peritoneal fluid, endometriotic lesions, peritoneum and macrophages). Animal models allow us to gather essential information on the origin, metabolism and effect of iron overload in endometriosis, which may originate from erythrocytes carried into the pelvic cavity mainly by retrograde menstruation. Peritoneal macrophages play an important role in the degradation of these erythrocytes and in subsequent peritoneal iron metabolism. Iron overload could affect a wide range of mechanisms involved in endometriosis development, such as oxidative stress or lesion proliferation. In conclusion, excess iron accumulation can result in toxicity and may be one of the factors contributing to the development of endometriosis. Treatment with an iron chelator could thus be beneficial in endometriosis patients to prevent iron overload in the pelvic cavity, thereby diminishing its deleterious effect.

To determine the incidence of reversible amenorrhea in women with breast cancer undergoing adjuvant anthracycline-based chemotherapy with or without docetaxel.