- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01558544
Cryopreservation of Ovarian Tissue
Cryopreservation of Ovarian Tissue for Potential In Vitro Maturation or Autologous Transplantation
Study Overview
Status
Intervention / Treatment
Detailed Description
Procedure: The patient will undergo preoperative sonographic assessment of both ovaries to determine if either ovary is diseased or compromised. Patient will undergo preoperative blood sampling to measure AMH, FSH, LH and estradiol as indicators of current ovarian function (less than 8 teaspoons) if time allows and assessment of ovarian reserve is appropriate; menopausal levels of FSH (≥ 30 miu/ml) will be a contraindication to participation in this study. The patient may have infectious disease testing as part of the evaluation for fertility preservation treatment. Patient will undergo preoperative assessment and clearance for surgery by an anesthesiologist.
Intraoperative management will include laparotomy or laparoscopy, depending on the individual patient's history, exam and oncology plans. Removal of one or both ovaries will depend on preoperative ovarian assessment and recommendation of the oncologist. If ovarian survival for the anticipated treatment has never been documented then both ovaries will be removed. Both ovaries may also be removed if diseased or if the condition requires prophylactic oophorectomy to prevent risk of malignant transformation, e.g. 46 XX/46 XY chimera and BRCA mutation carriers. If ovarian function has rarely been documented for the anticipated treatment then one ovary will be removed and one may be left in situ or repositioned to avoid the field of radiation. The decision to leave the ovary in situ or to reposition will be made pre-operatively by the physician performing the surgery in consultation with the patient and the radiation oncologist. If there is no normal ovarian tissue, as determined by pathology, we will take biopsies of ovarian tissue not to exceed 50% of the ovarian volume from the contra-lateral side for freezing. Additionally, the remaining ovary may be repositioned and sutured to the posterior wall of the uterus or above the pelvic brim with a radio-opaque clip placed to identify this ovary for shielding during irradiation.
Ovarian tissue will be removed and treated as follows: (a) the cortex will be stripped from the remaining ovarian tissue as this outer layer contains most of the immature eggs or primordial follicles. The cortex will be sectioned into 8mm x 1mm strips, each to be frozen in vials containing 1-3 strips. One strip will be sent to pathology for paraffin embedding to be available for future assessment of occult lymphoma cells markers; (b) the central or medullary portion will be frozen separately for potential scientific analysis since this section would not be of any clinical utility. The amount of tissue frozen may vary depending in part by whether one or two ovaries are removed. At some point in the future, thawing of ovarian tissue, with either in vitro maturation or autologous transplantation into the pelvis or other area of the body could be performed. The patient would receive routine postoperative care. The patient's oncologist will be consulted regarding proper timing of the surgery and the need for any special intraoperative or postoperative management
However, since the survival of the primordial follicles in transplanted ovarian tissue is quite low (<10%), methods for in vivo maturation of these eggs and improved methods of transplantation need to be developed. One or two vials of tissue (<10% of all tissue frozen) will be thawed to develop the techniques of maturing oocytes. This may include transplantation of the tissue into an animal model for in vivo maturation.
Six months to 1 year following surgery and/or treatment for the medical condition, eg chemotherapy, hormone testing will be performed for evaluation of ovarian reserve. This may include AMH and FSH hormone levels as well as pelvic ultrasounds and dominant antra follicle count.
If the subject does not wish to utilize the ovarian tissue for her own clinical use, the options include discarding the cryopreserved ovarian tissue or donating the cryopreserved tissue for approved research studies.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Rodriq E. Stubbs, NP
- Phone Number: 646-962-3276
- Email: res2011@med.cornell.edu
Study Locations
-
-
New York
-
New York, New York, United States, 10021
- Recruiting
- Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine
-
Contact:
- Mitasha C. Joseph, RN, MPA
- Phone Number: 646-962-3382
- Email: mij2008@med.cornell.edu
-
Principal Investigator:
- Glenn Schattman, MD
-
Contact:
- Rodriq Stubbs, NP
- Phone Number: 646-962-3276
- Email: res2011@med.cornell.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Females 0-45 years of age who are premenopausal
- Treatment plan that will likely result in premature menopause or premature ovarian failure
- This includes patients receiving:
- Cancer treatment with abdominal pelvic irradiation and/or high dose chemotherapy
- Surgery that requires removal of ovaries for medical condition or disease, e.g. Prophylactic oophorectomy in BRCA patients
- Patient is unable or unwilling to pursue fertility preservation by freezing oocytes or embryos.
- Previous treatment for cancer is acceptable if patient still has ovarian function
- Patient is medically stable enough to undergo surgery (cleared for anesthesia)
Exclusion Criteria:
- Patients not meeting the above criteria
- Patients who have not received medical clearance from their physicians to undergo surgery
- Patients already experiencing menopause.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Other: Use of high dose chemotherapy
Use of chemotherapy without removal of the disease ovary.
|
oophorectomy to remove a disease ovary.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
CRYOPRESERVATION OF OVARIAN TISSUE FOR POTENTIAL IN VITRO MATURATION OR AUTOLOGOUS TRANSPLANTATION
Time Frame: 6 months to a year post surgery, hormone testing will be performed to test ovarian function.
|
Ovarian tissue cryopreservation Survival of tissue undergoing cryopreservation, thawing and maturation of immature eggs.
|
6 months to a year post surgery, hormone testing will be performed to test ovarian function.
|
Collaborators and Investigators
Investigators
- Principal Investigator: Glenn Schattman, MD, Weill Medical College of Cornell University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 0901010165
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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