Jacques Donnez, Marie-Madeleine Dolmans

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Presentation transcript:

Natural hormone replacement therapy with a functioning ovary after the menopause: dream or reality? Jacques Donnez, Marie-Madeleine Dolmans Reproductive BioMedicine Online Volume 37, Issue 3, Pages 359-366 (September 2018) DOI: 10.1016/j.rbmo.2018.05.018 Copyright © 2018 Reproductive Healthcare Ltd. Terms and Conditions

Figure 1 The ovarian reserve throughout a woman's life, from conception to age 55 years. Only around 1000 follicles remain at menopause. Adapted from Wallace WH and Kelsey TW. PLOS ONE 27, e8772, 2010; published under an open-access license by PLoS. Donnez J and Dolmans MM propose ovarian tissue reimplantation when women reach the menopause. Ideally, their tissue should have been removed and frozen at the age of 20–25 years. Adapted from Wallace and Keysey, PLOS ONE, 2010. Reproductive BioMedicine Online 2018 37, 359-366DOI: (10.1016/j.rbmo.2018.05.018) Copyright © 2018 Reproductive Healthcare Ltd. Terms and Conditions

Figure 2 Life expectancy in the US (based on National Vital Statistics Reports [Volume 58, Number 21] and Smith and Bradshaw, 2006). Adapted from National Vital Statistics Reports Volume 58, number 21, and Smith and Bradshaw, Demography, 2006. Reproductive BioMedicine Online 2018 37, 359-366DOI: (10.1016/j.rbmo.2018.05.018) Copyright © 2018 Reproductive Healthcare Ltd. Terms and Conditions

Figure 3 Lobo's full circle (Lobo, Nature Reviews Endocrinology, 2017), giving rise to the timing hypothesis. Adapted from Lobo, Nature Reviews Endocrinology, 2017. HRT, hormone replacement therapy; MWS, Million Women Study; WHI, Women's Health Initiative. Reproductive BioMedicine Online 2018 37, 359-366DOI: (10.1016/j.rbmo.2018.05.018) Copyright © 2018 Reproductive Healthcare Ltd. Terms and Conditions

Figure 4 Long-term duration of ovarian function after orthotopic transplantation in a series of five women who had their ovarian tissue cryopreserved aged younger than 22 years. Adapted from Donnez and Dolmans, Journal of Assisted Reproduction and Genetics, 2015, and New England Journal of Medicine, 2017. Reproductive BioMedicine Online 2018 37, 359-366DOI: (10.1016/j.rbmo.2018.05.018) Copyright © 2018 Reproductive Healthcare Ltd. Terms and Conditions

Figure 5 Ovarian tissue freezing followed by reimplantation upon reaching menopause. Ovarian tissue may be grafted to a heterotopic site in the form of ovarian tissue strips, or inside an artificial ovary containing isolated primordial follicles (Based on Donnez and Dolmans, New England Journal of Medicine, 2017). Adapted from Donnez and Dolmans, New England Journal of Medicine, 2017. Reproductive BioMedicine Online 2018 37, 359-366DOI: (10.1016/j.rbmo.2018.05.018) Copyright © 2018 Reproductive Healthcare Ltd. Terms and Conditions