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Human ovarian gross morphology and sub-anatomy across puberty: insights from tissue donated during fertility preservation.

  • Elizabeth L. Tsui
    Affiliations
    Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA 60611

    Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, USA 60611
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  • Courtney J. Harris
    Affiliations
    Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, USA 60611

    Division of Pediatric Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA 60611
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  • Erin E. Rowell
    Affiliations
    Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, USA 60611

    Division of Pediatric Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA 60611
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  • Monica M. Laronda
    Correspondence
    Corresponding author: Name: Monica M. Laronda, Stanley Manne Children’s Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Assistant Professor, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, Stanley Manne Children’s Research Institute, 225 E Chicago Avenue, Box 205, Chicago, IL 60611, Phone: 312-503-5884,
    Affiliations
    Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA 60611

    Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, USA 60611

    Division of Pediatric Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA 60611
    Search for articles by this author
Open AccessPublished:February 22, 2023DOI:https://doi.org/10.1016/j.xfre.2023.02.008
Human ovarian gross morphology and sub-anatomy across puberty: insights from tissue donated during fertility preservation.
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      Structured Abstract

      Objective

      To study ovarian gross morphologic and sub-anatomic features across pubertal development.

      Design

      Prospective cohort study.

      Setting

      An academic medical center with specimens collected from 2018 to 2022.

      Patients

      Tissue was obtained from pre- and post-pubertal participants (0.19 to 22.96 years) undergoing ovarian tissue cryopreservation (OTC) prior to treatment that put them at significantly or high increased risk of developing premature ovarian insufficiency. Most participants (64%) had not received chemotherapy at tissue collection.

      Interventions

      None.

      Main Outcome Measures

      Ovaries procured for fertility preservation were weighed and measured. Ovarian tissue fragments released during processing, biopsies used for pathology, and hormone panels were analyzed for gross morphology, sub-anatomical features, and reproductive hormones. Graphical analysis of best fit lines determined age at maximum growth velocity.

      Results

      Pre-pubertal ovaries were significantly (1.4-fold and 2.4-fold) smaller than post-pubertal ovaries by length and width, and 5.7-fold lighter on average. Length, width, and weight grew in a sigmoidal pattern with age. Pre-pubertal ovaries were less likely to display a defined corticomedullary junction (53% vs. 77% in post-pubertal specimens), less likely to have a tunica albuginea (22% vs. 93% in post-pubertal specimens), contained significantly more (9.8-fold) primordial follicles, and contained primordial follicles at significantly deeper depths (2.9-fold) compared to post-pubertal ovaries.

      Conclusions

      OTC tissue is a resource to study human ovarian biology and pubertal development. Maximum growth velocity occurs late within the pubertal transition (Tanner 3+) following changes in sub-anatomical features. This ovarian morphology model adds to foundational knowledge of human ovarian development and supports ongoing transcriptomics research.

      Key Words

      Article info

      Publication history

      Accepted: February 17, 2023
      Received in revised form: February 16, 2023
      Received: November 8, 2022

      Publication stage

      In Press Accepted Manuscript

      Footnotes

      Funding Statement: This work was supported in part by the Children’s Research Fund, the Ann & Robert H. Lurie Children’s Hospital Faculty Practice Plan award (MML, EER), the Warren and Eloise Batts Research Scholar (MML), the Burroughs Wellcome Fund Career Award at the Scientific Interface (1014568, MML), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD104683 and U01HD110336, MML), and the Mary and Ralph Gesualdo Family Foundation. ET was supported in part by National Institutes of Health/National Cancer Institute training grant T32 CA009560, National Research Service Award F30HD107966-01, and the Northwestern University Medical Scientist Training Program (MSTP) T32GM008152 (ET).

      Disclosure Statement: MML is an Advisor for Dimension Inx, LLC.

      Attestation Statement:

      The subjects in this trial have not concomitantly been involved in other randomized trials (If applicable).

      Data regarding any of the subjects in the study has not been previously published unless specified.

      Data will be made available to the editors of the journal for review or query upon request.

      Data Sharing Statement: The data underlying this article cannot be shared publicly for the privacy of individuals that participated in the study. The data will be shared on reasonable request to the corresponding author.

      Identification

      DOI: https://doi.org/10.1016/j.xfre.2023.02.008

      Copyright

      © 2023 The Author(s). Published by Elsevier Inc. on behalf of American Society for Reproductive Medicine.

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