FILE - In this May 26, 2012, file photo, former major league baseball player Reggie Jackson appears before a baseball game between the Oakland Athletics and the New York Yankees in Oakland, Calif. The Yankees want Reggie Jackson to steer clear of the clubhouse and team events following his pointed remarks about Alex Rodriguez and several former stars, a person familiar with the situation told The Associated Press on Monday, July 9. (AP Photo/Jeff Chiu, File)
FILE - In this May 26, 2012, file photo, former major league baseball player Reggie Jackson appears before a baseball game between the Oakland Athletics and the New York Yankees in Oakland, Calif. The Yankees want Reggie Jackson to steer clear of the clubhouse and team events following his pointed remarks about Alex Rodriguez and several former stars, a person familiar with the situation told The Associated Press on Monday, July 9. (AP Photo/Jeff Chiu, File)
NEW YORK (AP) ? The New York Yankees have told Mr. October to stay away this summer.
The Yankees want Reggie Jackson to steer clear of the clubhouse and team events following his pointed remarks about Alex Rodriguez and several former stars, a person familiar with the situation told The Associated Press on Monday.
The Hall of Famer will lay low for several weeks, the person told the AP on condition of anonymity because there was no formal announcement. Jackson was not disciplined or fined, and will remain as a special adviser to the Yankees.
ESPN initially reported Jackson would be indefinitely absent from the Yankees.
Jackson recently was quoted by Sports Illustrated as saying some of Rodriguez's statistics were tainted because the Yankees slugger had admitted using performance-enhancing drugs. Jackson has spoken to Rodriguez since then to explain his comments.
Jackson also said he didn't see Gary Carter, Kirby Puckett and others as Hall of Famers.
The MVP of the 1977 World Series with the Yankees was told not to travel to Boston last weekend for New York's four-game series at Fenway Park to avoid becoming a distraction. The Yankees will contact Jackson when they want him back on the scene, the person said.
Jackson was on the field in Kansas City on Monday night for the All-Star Home Run Derby and waved to the crowd. He did not hold an interview session.
Jackson told SI that A-Rod was a friend, adding: "But I think there are real questions about his numbers. As much as I like him, what he admitted about his usage does cloud some of his records."
The former star also said there were several players that he didn't view as worthy of Cooperstown.
"I didn't see Kirby Puckett as a Hall of Famer. I didn't see Gary Carter as a Hall of Famer. I didn't see Don Sutton as a Hall of Famer. I didn't see Phil Niekro as a Hall of Famer. As much as I like Jim Rice, I'm not so sure he's a Hall of Famer," Jackson was quoted by SI.
Carter died in February and several former players have criticized the timing of Jackson's remarks. The person indicated Jackson was reaching out to the families of Carter and Puckett, as well as the Hall of Famers he mentioned.
The latest research has discovered that customer service has rated higher in the priority stakes than price for most consumers. This research was carried out by the company Aspect, who found that customer service is the highest influencing factor for 38% of consumers when choosing a bank to do business with. Price actually came in with only 25% of people saying that this was most important to them.
These days, consumers regard the quality of customer service as one of the most important factors when deciding on a service such as a bank or retailer. This is based on the fact that consumers who build close relationships with service providers on the basis of quality customer service are more likely to remain loyal to the brand rather than switching to a competitor.
This complements other research that also suggests that customer service is key to consumers. Research from Accenture discovered that 25% of consumers had and would again swap their retailer for a competitor if their customer service had not been up to scratch.
Customer loyalty is very important to businesses. ?As a business it is generally a lot easier to maintain your current customers than it is to gain new ones. Reputation is therefore also vital for a company, as they wish to maintain a certain level of professionalism and a strong reputation for being a consumer led brand, something which they need to backup with solid customer service facilities.
This research calls upon businesses that have customer call/contact centres in place as a point of call for customer service to adopt the efficient call centre technologies needed to provide great customer care. As well as this, businesses need to ensure that they have the processes and staff training programs in place in order to deliver the customer service that is expected of them by their customers. These steps are essential to improving customer loyalty and establishing brand reputation.
The research also found that switching to competitors has never been easier, with many consumers commenting that although they may regularly use a brand for their weekly shopping, the moment that they become disappointed by a brand then they can quickly and easily switch to another store. This again reiterates the point that with the number of competitors in the marketplace, consumers will no longer accept being dissatisfied with customer service.
Slate's?New York office?is also seeking highly energetic, self-starting individuals who have a nose for news, along with sharp and quick writing skills, to contribute to our news blog,?The Slatest. Applicants should be tech-savvy and have great editorial judgment. Previous reporting experience is a plus, and the ability to write clean, quick, and clear copy is a must. This position is unpaid, and candidates?must be currently enrolled in college or grad school to apply. This internship is part-time, two full days a week, starting this fall. Applicants must be able to work out of?Slate?s New York office. Please send a r?sum? and very brief statement of interest to?slatestjob@gmail.com. Deadline is August 1, 2012.
U.S. Secretary of State Hillary Rodham Clinton delivers opening remarks to the Community of Democracies Governing Council at the Ministry of Foreign Affairs Monday, July 9, 2012 in Ulan Bator, Mongolia. (AP Photo/Brendan Smialowski, Pool)
U.S. Secretary of State Hillary Rodham Clinton delivers opening remarks to the Community of Democracies Governing Council at the Ministry of Foreign Affairs Monday, July 9, 2012 in Ulan Bator, Mongolia. (AP Photo/Brendan Smialowski, Pool)
U.S. Secretary of State Hillary Rodham Clinton, left, listens as Mongolian President Elbegdori Tsakhia, right, delivers the opening remarks to the Community of Democracies Governing Council, at the Ministry of Foreign Affairs Monday, July 9, 2012 in Ulan Bator, Mongolia. (AP Photo/Brendan Smialowski, Pool)
U.S. Secretary of State Hillary Rodham Clinton, left, is greeted by Mongolian President Elbegdorj Tsakhia during their meeting at the President's Yurt Monday, July 9, 2012 in Ulan Bator, Mongolia. (AP Photo/Brendan Smialowski, Pool)
U.S. Secretary of State Hillary Rodham Clinton, center, is greeted during an arrival ceremony at the Government House Monday, July 9, 2012 in Ulan Bator, Mongolia. (AP Photo/Brendan Smialowski, Pool)
U.S. Secretary of State Hillary Rodham Clinton, center left, is greeted during an arrival ceremony at the Government House Monday, July 9, 2012 in Ulan Bator, Mongolia. (AP Photo/Brendan Smialowski, Pool)
ULAN BATOR, Mongolia (AP) ? Secretary of State Hillary Rodham Clinton took aim Monday at China's model of economic growth without democracy, arguing that it undermines long-term prospects and urging other Asian countries to expand markets and political freedom at the same time.
Without mentioning Beijing by name, Clinton laid out a week of diplomatic efforts she'll make across Asia to press governments into improving the rule of law and free expression. Speaking at a woman's event in Mongolia, China's northern neighbor, she said limiting freedom "kills innovation and discourages entrepreneurship," and ultimately undermines economic expansion.
"We need to make the 21st century a time in which people across Asia don't only become more wealthy," she said. "They must also become more free."
The message reflects the battle of values between Washington and Beijing as they jostle for strategic and economic advantages across the continent. President Barack Obama has tried to pivot U.S. power to the region, in part to reverse a slide toward China in recent years as its economy boomed and America's struggled.
Clinton, who'll also visit Vietnam, Laos and Cambodia over the next five days, held up Mongolia as a positive example of advancement. Having visited the country once before, as first lady in 1995, she returned to the capital of Ulan Bator via a potholed road undergoing expansion, past billboards advertising Western firms and skyscrapers sprouting up amidst the Soviet-era architectural relics dominating the cityscape.
She was formally welcomed below a giant statue of Genghis Khan across the city's communist-era central plaza from a Louis Vuitton shop, further underscoring the old and new Mongolia and reflecting its rapidly expanding wealth.
"My trip reflects a strategic priority of American foreign policy today," Clinton said. "After 10 years in which we focused a great deal of attention on the conflicts in Afghanistan and Iraq, the United States is making substantially increased investments ? diplomatic, economic, strategic and otherwise ? in this part of the world. It's what we call our pivot toward Asia."
A country more than twice the size of Texas with only 2.7 million people, Mongolia is tapping into its huge deposits of gold, copper, coal and other natural resources. But unlike its neighbors, undemocratic China and increasingly authoritarian Russia, Mongolia's expansion in wealth has been accompanied by greater freedom for its people.
Clinton stressed this point, but her visit also comes as international mining companies scramble for some of the country's mineral wealth. The prize is a share of Tavan Tolgoi, a coal field with estimated reserves of 6.4 billion tons just 200 kilometers from China, the world's biggest consumer of coal. Among the bidders for a strategic stake is Peabody Energy, a St. Louis-based coal mining titan that has lobbied Washington to support its bid.
Mongolia has also contributed to U.S. strategic interests. It has sent troops to Afghanistan and Iraq, and to U.N. peacekeeping operations in Africa, part of a foreign policy designed to carve out protection for itself against Chinese and Russian domination.
Clinton said she remained inspired by Mongolia's transition to democracy in the 1990s and the six successful rounds of parliamentary elections it has held. "Against long odds, surrounded by powerful neighbors who had their own ideas for Mongolia's future, the Mongolian people came together with great courage to transform a one-party communist dictatorship into a pluralistic political system," she said.
She contrasted Mongolia's path with that of other Asian governments who've fought the trend toward greater liberty, while also holding up the democratic achievements in Thailand, Taiwan and even Burma to dispel the notion that democracy is antithetical to Asian values. She rejected suggestions that democracy upsets stability or is a privilege for the wealthy.
"This is the right time to talk about democracy in Asia, as many countries in this region grapple with the question of which model of governance best suits their society and circumstances," she said. "The path they choose will shape the lives of billions of people and the future of this region."
FILE - In an April 12, 2012 file photo, Artyom Savelyev, a 9-year-old Russian boy, is in a foster home in Tomilino, outside Moscow, Russia. Russia?s parliament on Tuesday, July 10, 2012 ratified an agreement with the United States which would regulate the adoption of Russian children by Americans. Russian first voiced its grievances about the fate of Russian children adopted in the United States when Savelyev, then 7, was sent back to Russia on a one-way plane ticket by his adoptive mother from Tennessee. The boy's treatment ignited outrage in Russia toward the United States, temporarily halting American adoptions of Russian children. (AP Photo/Misha Japaridze, File)
FILE - In an April 12, 2012 file photo, Artyom Savelyev, a 9-year-old Russian boy, is in a foster home in Tomilino, outside Moscow, Russia. Russia?s parliament on Tuesday, July 10, 2012 ratified an agreement with the United States which would regulate the adoption of Russian children by Americans. Russian first voiced its grievances about the fate of Russian children adopted in the United States when Savelyev, then 7, was sent back to Russia on a one-way plane ticket by his adoptive mother from Tennessee. The boy's treatment ignited outrage in Russia toward the United States, temporarily halting American adoptions of Russian children. (AP Photo/Misha Japaridze, File)
MOSCOW (AP) ? Russia's parliament on Tuesday ratified a long-awaited agreement with the United States regulating the adoption of Russian children by Americans.
The ratification by a 244-96-2 vote in the State Duma came a year after the two countries worked out the pact.
Key questions and answers about the agreement:
HOW DID THE AGREEMENT COME ABOUT?
Russian officials had long complained about the abuse and even killings of children by their adoptive parents ? saying at least 19 Russian adoptive children have died at their American parents' hands.
The issue came to a head in April 2010 when an American adoptive mother sent her 7-year-old boy back to Russia on a one-way ticket, saying he had behavioral problems.
In the wake of that case, some Russian officials called for adoptions by Americans to be halted altogether. That never happened, but some adoption agencies working in Russia said their applications were frozen for several months.
Russian and U.S. officials signed an agreement aimed at ending the dispute in 2011, but the Russian parliament waited nearly a year to ratify it due to technicalities.
WHAT DOES IT MEAN FOR AMERICANS WHO WANT TO ADOPT RUSSIAN CHILDREN
Ratification should end the strife and allow adoptions to resume efficiently.
All adoptions would have to be processed through adoption agencies registered in Russia. The agreement requires the agencies to monitor the child's upbringing, schedule visits by a social worker and send reports to Russian authorities.
The deal makes sure that prospective American parents would have better information about the social and medical histories of Russian children.
HOW WILL IT IMPACT RUSSIA?
By providing monitoring, the agreement is likely to reassure a public angered by the abuse and deaths. It also could undercut complaints by nationalists that Russian children are being "sold."
The poorly controlled flow of Russian adoptions highlighted sensitivity over the loss of children as Russia faces a demographic crisis due to low birth rates.
Full resumption of adoptions will mean increased opportunity for Russian orphans to leave underfunded and crowded orphanages. There are more than 740,000 children without parental custody in Russia, according to UNICEF. Russians historically have been less inclined to adopt children than in many other cultures.
WHY IS THE DEAL IMPORTANT FOR AMERICANS?
Russia has been a major source of adopted children in the U.S. for two decades.
In the 2011 fiscal year, Russia was the third-largest source of foreign adoption by Americans with 970 adoptions, trailing China and Ethiopia.
Adoptions from Russia peaked in 2004 at 5,862 adoptions, according to the State Department. Their number was 1,586 in 2009 ? a year before Russia demanded an agreement regulating adoptions.
More than 60,000 Russian orphans have been adopted in the U.S., according to the National Council For Adoption, a U.S. advocacy nonprofit group. Russian children rights ombudsman Pavel Astakhov insists that the number could be as high as 100,000. The discrepancy could be due to the Russian government's virtual absence of adoption records before 1996.
RECENT ALLEGATIONS OF ABUSE OF RUSSIAN ADOPTED CHILDREN
Michael and Nanette Craver from Pennsylvania were sentenced in 2011 to up to four years in prison for involuntary manslaughter of their adoptive 7-year-old Russian son. A jury acquitted them of murder charges, but concluded they were negligent and responsible for the death.
Jessica Beagley from Alaska was convicted in 2011 of child abuse for pouring hot sauce into her adopted Russian son's mouth.
In May, Martin and Kathleen O'Brien from Wisconsin were charged with an array of counts connected to allegations they systematically punished their four adopted Russian children, including beatings with sticks and belts. Their trial is ongoing.
[ [ [['Connery is an experienced stuntman', 2]], 'http://yhoo.it/KeQd0p', '[Slideshow: See photos taken on the way down]', ' ', '630', ' ', ' ', ], [ [['Connery is an experienced stuntman', 7]], ' http://yhoo.it/KpUoHO', '[Slideshow: Death-defying daredevils]', ' ', '630', ' ', ' ', ], [ [['know that we have confidence in', 3]], 'http://yhoo.it/LqYjAX ', '[Related: The Secret Service guide to Cartagena]', ' ', '630', ' ', ' ', ], [ [['We picked up this other dog and', 5]], 'http://yhoo.it/JUSxvi', '[Related: 8 common dog fears, how to calm them]', ' ', '630', ' ', ' ', ], [ [['accused of running a fake hepatitis B', 5]], 'http://bit.ly/JnoJYN', '[Related: Did WH share raid details with filmmakers?]', ' ', '630', ' ', ' ', ], [ [['accused of running a fake hepatitis B', 3]], 'http://bit.ly/KoKiqJ', '[Factbox: AQAP, al-Qaeda in Yemen]', ' ', '630', ' ', ' ', ], [ [['have my contacts on or glasses', 3]], 'http://abcn.ws/KTE5AZ', '[Related: Should the murder charge be dropped?]', ' ', '630', ' ', ' ', ], [ [['have made this nation great as Sarah Palin', 5]], 'http://yhoo.it/JD7nlD', '[Related: Bristol Palin reality show debuts June 19]', ' ', '630', ' ', ' ', ], [ [['have made this nation great as Sarah Palin', 1]], 'http://bit.ly/JRPFRO', '[Related: McCain adviser who vetted Palin weighs in on VP race]', ' ', '630', ' ', ' ', ], [ [['A JetBlue flight from New York to Las Vegas', 3]], 'http://yhoo.it/GV9zpj', '[Related: View photos of the JetBlue plane in Amarillo]', ' ', '630', ' ', ' ', ], [ [['the 28-year-old neighborhood watchman who shot and killed', 15]], 'http://news.yahoo.com/photos/white-house-stays-out-of-teen-s-killing-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/cv/ip/ap/default/120411/martinzimmermen.jpg', '630', ' ', 'AP', ], [ [['He was in shock and still strapped to his seat', 6]], 'http://news.yahoo.com/photos/navy-jet-crashes-in-virginia-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/cv/ip/ap/default/120406/jet_ap.jpg', '630', ' ', 'AP', ], [ [['xxxxxxxxxxxx', 11]], 'http://news.yahoo.com/photos/russian-grannies-win-bid-to-sing-at-eurovision-1331223625-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/a/p/us/news/editorial/1/56/156d92f2760dcd3e75bcd649a8b85fcf.jpeg', '500', ' ', 'AP', ] ]
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Fertility preservation with cryopreservation of ovarian tissue: from experimental to mainstreamPublic release date: 4-Jul-2012 [ | E-mail | Share ]
Contact: Christine Bauquis christine@eshre.eu 32-499-258-046 European Society of Human Reproduction and Embryology
Italy's first successful case shows that time in freeze-storage is no barrier to success
Istanbul, 4 July 2012: Although the first successful preservation of fertility from the freezing, thawing and grafting of ovarian tissue was reported eight years ago,(1) the technique has remained experimental and confined to a few specialist centres. Now, with the announcement of a first pregnancy (and subsequent live birth) in Italy following the transplantation of ovarian tissue, there are indications that fertility preservation is moving into the mainstream of reproductive medicine and into a greater number of centres.(2)
"Fertility preservation is now a key component of the management of young cancer patients," said Dr Gianluca Gennarelli from Clinica Universitaria Sant'Anna in Turin, presenting details of the Italian pregnancy at the annual meeting of ESHRE (European Society of Human Reproduction and Embryology). "Though still a challenging procedure, the cryopreservation of ovarian cortex should still be offered to young women and girls ahead of potentially gonadotoxic cancer treatments with a high risk of ovarian failure," he said.
The Italian case described by Dr Gennarelli was remarkable not just because it is Italy's first successful pregnancy and delivery, but also because - with a gap of seven years - it represents one of the longest time intervals yet between the date of tissue freezing and the date of successful transplantation.(3) "It demonstrates that pregnancy can be obtained by this technique even after several years of cryostorage," said Dr Gennarelli.
The case involved a 21-year-old patient scheduled for high dose chemotherapy and bone marrow transplantation. Just before treatment, in July 2003, she was referred for fertility preservation, with ovarian cortical tissue collected by laparoscopy. Bilateral biopsies of ovarian cortex were sampled (ie, from both ovaries), frozen by slow freezing and stored in liquid nitrogen. As feared, chemotherapy was followed by ovarian failure.
In March 2010, following the patient's request and investigation for fertility restoration, 32 cortical tissue fragments were thawed and sutured to prepared sites. Two months after the tissue grafting, some ovarian function returned and spontaneous follicular development was observed. Over the following months spontaneous menstrual cycles were repeatedly evident and ovulation was confirmed in at least six cycles. In July 2011, 15 months after the ovarian tissue transplantation, the patient became spontaneously pregnant, and a healthy baby was delivered in March 2012.
The birth is believed to be the 22nd in the world from this technique, and a new indication that the restoration of fertility by this technique is feasible, rapidly evolving and worthwhile for a growing number of patients. Given the increase in cancer survival, and the likelihood that many successfully treated young women and girls will live to enjoy their "reproductive" years, interest in the technique - from both patients and doctors - is sure to grow, said Dr Gennarelli.
The cryopreservation of ovarian tissue is not the only technique suitable for young women, and there is also growing interest in oocyte cryopreservation (especially with developments in vitrification). However, both embryo and oocyte storage require a cycle of ovarian stimulation and collection, which may not be suitable for women with hormone-dependent cancers or for those who need immediate cancer treatment. The storage of ovarian tissue - which may be performed at short notice - overcomes both those problems.
Nevertheless, Dr Gennarelli conceded that the number of successful cases of fertility restoration is not great, especially in relation to the number of tissue samples now in storage. A further poster presented at this congress - from some of the leading groups in the field - reported that most patients having autologous transplantation of ovarian tissue did so with the intention of having a child, but the recovery of hormonal function was also very important to them. Most transplanted women did recover their ovarian function.(4)
"We and other groups now believe that ovarian tissue freezing for fertility preservation should not be considered experimental but be recognised as a routine clinical practice to be offered in appropriate cases," said Dr Gennarelli. "Age, for example, is one important consideration."
On the question of time between tissue biopsy, freezing and transplantation, Dr Gennarelli said: "We are not aware, so far, of any time limit for cryopreserved ovarian tissue. The recent report by the group of Jacques Donnez further prolongs that time interval even further."
Despite the wider application of ovarian tissue storage for fertility preservation, the relatively small number of babies born suggests that far fewer women after their cancer treatment are taking up their options for pregnancy. "The reasons are probably many," said Dr Gennarelli, "but the simplest might be that not so many patients have reached the age or the decision to conceive. Nevertheless, the babies born worldwide so far indicate that we're moving in the right direction."
###
Notes
1. Donnez J, Dolmans MM, Demylle D, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 364: 1405-1410
2. Future fertility is of increasing importance to cancer patients. One study of more than 600 women with breast cancer indicated that 73% of them expressed some concern about the possibility of becoming infertile after treatment. As a result of earlier detection, advanced treatments and better survival rates in female cancers, interest in fertility preservation techniques is growing. The main techniques for women are embryo and oocyte cryopreservation (which each require ovarian stimulation and egg collection), ovarian suppression (with drugs) during chemo- and radiotherapy, and ovarian tissue cryopreservation. Many research questions remain, but all techniques require the collaborating involvement of specialists in cancer and reproductive medicine.
3. Until very recently, this live birth in Turin was believed to represent the longest time interval between tissue freezing and transplantation for pregnancy. However, an online report on 14 June from the Belgian group of Jacques Donnez describes a gap of ten years between freezing and pregnancy (Donnez J, Jadoule P, Pirard C, et al. Live birth after transplantation of frozen-thawed ovarian tissue after bilateral oophorectomy for benign disease. Fertil Steril 2012; doi:10.1016/j.fertnstert.2012.05.017).
4. Sanchez-Serrano1 M, Dolmans MM, Greve T, Pellicer A, Donnez J. Yding Andersen C. Ovarian function after ovarian tissue autotransplantation; global results in Belgium, Denmark and Spain. Poster 348, ESHRE annual meeting 2012.
Presented as a poster (P-346)
First pregnancy in Italy after autologous orthotopic ovarian tissue grafting
Note: When obtaining outside comment, journalists are requested to ensure that their contacts are aware of the embargo on this release.
The 28th Annual Meeting of ESHRE, the world's largest event in reproductive science and medicine, is taking place in Istanbul from 1-4 July 2012
[ | E-mail | Share ]
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Fertility preservation with cryopreservation of ovarian tissue: from experimental to mainstreamPublic release date: 4-Jul-2012 [ | E-mail | Share ]
Contact: Christine Bauquis christine@eshre.eu 32-499-258-046 European Society of Human Reproduction and Embryology
Italy's first successful case shows that time in freeze-storage is no barrier to success
Istanbul, 4 July 2012: Although the first successful preservation of fertility from the freezing, thawing and grafting of ovarian tissue was reported eight years ago,(1) the technique has remained experimental and confined to a few specialist centres. Now, with the announcement of a first pregnancy (and subsequent live birth) in Italy following the transplantation of ovarian tissue, there are indications that fertility preservation is moving into the mainstream of reproductive medicine and into a greater number of centres.(2)
"Fertility preservation is now a key component of the management of young cancer patients," said Dr Gianluca Gennarelli from Clinica Universitaria Sant'Anna in Turin, presenting details of the Italian pregnancy at the annual meeting of ESHRE (European Society of Human Reproduction and Embryology). "Though still a challenging procedure, the cryopreservation of ovarian cortex should still be offered to young women and girls ahead of potentially gonadotoxic cancer treatments with a high risk of ovarian failure," he said.
The Italian case described by Dr Gennarelli was remarkable not just because it is Italy's first successful pregnancy and delivery, but also because - with a gap of seven years - it represents one of the longest time intervals yet between the date of tissue freezing and the date of successful transplantation.(3) "It demonstrates that pregnancy can be obtained by this technique even after several years of cryostorage," said Dr Gennarelli.
The case involved a 21-year-old patient scheduled for high dose chemotherapy and bone marrow transplantation. Just before treatment, in July 2003, she was referred for fertility preservation, with ovarian cortical tissue collected by laparoscopy. Bilateral biopsies of ovarian cortex were sampled (ie, from both ovaries), frozen by slow freezing and stored in liquid nitrogen. As feared, chemotherapy was followed by ovarian failure.
In March 2010, following the patient's request and investigation for fertility restoration, 32 cortical tissue fragments were thawed and sutured to prepared sites. Two months after the tissue grafting, some ovarian function returned and spontaneous follicular development was observed. Over the following months spontaneous menstrual cycles were repeatedly evident and ovulation was confirmed in at least six cycles. In July 2011, 15 months after the ovarian tissue transplantation, the patient became spontaneously pregnant, and a healthy baby was delivered in March 2012.
The birth is believed to be the 22nd in the world from this technique, and a new indication that the restoration of fertility by this technique is feasible, rapidly evolving and worthwhile for a growing number of patients. Given the increase in cancer survival, and the likelihood that many successfully treated young women and girls will live to enjoy their "reproductive" years, interest in the technique - from both patients and doctors - is sure to grow, said Dr Gennarelli.
The cryopreservation of ovarian tissue is not the only technique suitable for young women, and there is also growing interest in oocyte cryopreservation (especially with developments in vitrification). However, both embryo and oocyte storage require a cycle of ovarian stimulation and collection, which may not be suitable for women with hormone-dependent cancers or for those who need immediate cancer treatment. The storage of ovarian tissue - which may be performed at short notice - overcomes both those problems.
Nevertheless, Dr Gennarelli conceded that the number of successful cases of fertility restoration is not great, especially in relation to the number of tissue samples now in storage. A further poster presented at this congress - from some of the leading groups in the field - reported that most patients having autologous transplantation of ovarian tissue did so with the intention of having a child, but the recovery of hormonal function was also very important to them. Most transplanted women did recover their ovarian function.(4)
"We and other groups now believe that ovarian tissue freezing for fertility preservation should not be considered experimental but be recognised as a routine clinical practice to be offered in appropriate cases," said Dr Gennarelli. "Age, for example, is one important consideration."
On the question of time between tissue biopsy, freezing and transplantation, Dr Gennarelli said: "We are not aware, so far, of any time limit for cryopreserved ovarian tissue. The recent report by the group of Jacques Donnez further prolongs that time interval even further."
Despite the wider application of ovarian tissue storage for fertility preservation, the relatively small number of babies born suggests that far fewer women after their cancer treatment are taking up their options for pregnancy. "The reasons are probably many," said Dr Gennarelli, "but the simplest might be that not so many patients have reached the age or the decision to conceive. Nevertheless, the babies born worldwide so far indicate that we're moving in the right direction."
###
Notes
1. Donnez J, Dolmans MM, Demylle D, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 364: 1405-1410
2. Future fertility is of increasing importance to cancer patients. One study of more than 600 women with breast cancer indicated that 73% of them expressed some concern about the possibility of becoming infertile after treatment. As a result of earlier detection, advanced treatments and better survival rates in female cancers, interest in fertility preservation techniques is growing. The main techniques for women are embryo and oocyte cryopreservation (which each require ovarian stimulation and egg collection), ovarian suppression (with drugs) during chemo- and radiotherapy, and ovarian tissue cryopreservation. Many research questions remain, but all techniques require the collaborating involvement of specialists in cancer and reproductive medicine.
3. Until very recently, this live birth in Turin was believed to represent the longest time interval between tissue freezing and transplantation for pregnancy. However, an online report on 14 June from the Belgian group of Jacques Donnez describes a gap of ten years between freezing and pregnancy (Donnez J, Jadoule P, Pirard C, et al. Live birth after transplantation of frozen-thawed ovarian tissue after bilateral oophorectomy for benign disease. Fertil Steril 2012; doi:10.1016/j.fertnstert.2012.05.017).
4. Sanchez-Serrano1 M, Dolmans MM, Greve T, Pellicer A, Donnez J. Yding Andersen C. Ovarian function after ovarian tissue autotransplantation; global results in Belgium, Denmark and Spain. Poster 348, ESHRE annual meeting 2012.
Presented as a poster (P-346)
First pregnancy in Italy after autologous orthotopic ovarian tissue grafting
Note: When obtaining outside comment, journalists are requested to ensure that their contacts are aware of the embargo on this release.
The 28th Annual Meeting of ESHRE, the world's largest event in reproductive science and medicine, is taking place in Istanbul from 1-4 July 2012
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The latest research has discovered that customer service has rated higher in the priority stakes than price for most consumers. This research was carried out by the company Aspect, who found that customer service is the highest influencing factor for 38% of consumers when choosing a bank to do business with. Price actually came in with only 25% of people saying that this was most important to them.![[ Back to EurekAlert! ]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_sM4Yna_WnYARK_cD4Knsmm0ELas-xn9W6qZAZE8GPhldGdtMeCJgr97L62MFnqvN_pCf55RZ_FFRL00KNaTYKN7NCgfdpSs6kGmcJkkB4=s0-d){kind=small}
Public release date: 4-Jul-2012
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