A safe technique to isolate primordial follicles in patients with leukemia.

Objective: First, to evaluate the safety of our follicle isolation procedure when ovarian tissue is contaminated with cancer cells. Second, to develop a technique to eliminate cancer cells from the follicle suspension without altering follicle viability. Design: Experimental prospective study. Setting: Academic research unit. Patients: Ten women undergoing laparoscopy for benign gynecologic disease. Intervention: Ovarian biopsies were enzymatically dissociated. A leukemic cell line marked with a fluorescent tracer was added to the digested ovarian tissue suspension. In group 1, follicle suspension was obtained by the usual pick-up technique without further treatment. In group 2, follicle suspensions underwent mechanical purging after pick-up. Main Outcome Measures: Presence of leukemic cells in the follicle suspension and follicle viability, using fluorescence microscopy. Results: Two hundred and twenty-two leukemic cells were detected among 551 retrieved picked-up follicles in group 1, while just 1 leukemic cell was found among the 772 follicles in group 2. Follicle viability was similar in both groups (95%). Conclusion: This first study on the subject shows that our follicle pick-up technique is potentially unsafe for patients with leukemia. However, a simple mechanical purging procedure proved effective in eliminating leukemic cells retrieved along with follicles, while maintaining good follicle viability. These results need to be confirmed with ovarian tissue from leukemia patients