Skip to main content
Top
Published in: Journal of Ovarian Research 1/2019

Open Access 01-12-2019 | Fertility | Research

Decellularization of the mouse ovary: comparison of different scaffold generation protocols for future ovarian bioengineering

Authors: Ahmed Baker Alshaikh, Arvind Manikantan Padma, Matilda Dehlin, Randa Akouri, Min Jong Song, Mats Brännström, Mats Hellström

Published in: Journal of Ovarian Research | Issue 1/2019

Login to get access

Abstract

Background

In order to preserve fertility in young women with disseminated cancer, e.g. leukemia, an approach that has been suggested is to retransplant isolated small follicles within an ovarian matrix free from malignant cells and with no risk for contamination. The present study evaluates the first step to create a bioengineered ovarian construct that can act as growth-supporting tissue for isolated small follicles that are dependent on a stroma for normal follicular maturation. The present study used the intact mouse ovary to develop a mouse ovarian scaffold through various protocols of decellularization.

Material and methods

Potential Immunogenic DNA and intracellular components were removed from whole mouse ovaries by agitation in a 0.5% sodium dodecyl sulfate solution (Protocol 1; P1), or in a 2% sodium deoxycholate solution (P2) or by a combination of the two (P3). The remaining decelluralized ovarian extracellular matrix structure was then assessed based on the DNA- and protein content, and was further evaluated histologically by haematoxylin and eosin-, Verhoeff’s van gieson- (for elastin), Masson’s trichrome- (for collagens) and Alcian blue (for glycosaminoglycans) staining. We also evaluated the decellularization efficiency using the mild detergent Triton-X100 (1%).

Results

Sodium dodecyl sulfate efficiently removed DNA and intracellular components from the ovarian tissue but also significantly reduced the integrity of the remaining ovarian extracellular matrix. Sodium deoxycholate, a considerably milder detergent compared to sodium dodecyl sulfate, preserved the ovarian extracellular matrix better, evident by a more distinct staining for glycosaminoglycan, collagen and elastic fibres. Triton-X100 was found ineffective as a decellularization reagent for mouse ovaries in our settings.

Conclusions

The sodium dodecyl sulfate generated ovarian scaffolds contained minute amounts of DNA that may be an advantage to evade a detrimental immune response following engraftment. The sodium deoxycholate generated ovarian scaffolds had higher donor DNA content, yet, retained the extracellular composition better and may therefore have improved recellularization and other downstream bioengineering applications. These two novel types of mouse ovarian scaffolds serve as promising scaffold-candidates for future ovarian bioengineering experiments.
Literature
1.
go back to reference Pereira N, Schattman GL. Fertility preservation and sexual health after Cancer therapy. J Oncol Pract. 2017;13(10):643–51.CrossRef Pereira N, Schattman GL. Fertility preservation and sexual health after Cancer therapy. J Oncol Pract. 2017;13(10):643–51.CrossRef
2.
go back to reference Wallace WH, Thomson AB, Kelsey TW. The radiosensitivity of the human oocyte. Hum Reprod. 2003;18(1):117–21.CrossRef Wallace WH, Thomson AB, Kelsey TW. The radiosensitivity of the human oocyte. Hum Reprod. 2003;18(1):117–21.CrossRef
3.
go back to reference van Dorp W, Mulder RL, Kremer LC, Hudson MM, van den Heuvel-Eibrink MM, van den Berg MH, et al. Recommendations for premature ovarian insufficiency surveillance for female survivors of childhood, adolescent, and young adult Cancer: a report from the international late effects of childhood Cancer guideline harmonization Group in Collaboration with the PanCareSurFup consortium. J Clin Oncol. 2016;34(28):3440–50.CrossRef van Dorp W, Mulder RL, Kremer LC, Hudson MM, van den Heuvel-Eibrink MM, van den Berg MH, et al. Recommendations for premature ovarian insufficiency surveillance for female survivors of childhood, adolescent, and young adult Cancer: a report from the international late effects of childhood Cancer guideline harmonization Group in Collaboration with the PanCareSurFup consortium. J Clin Oncol. 2016;34(28):3440–50.CrossRef
4.
go back to reference Ben-Aharon I, Granot T, Meizner I, Hasky N, Tobar A, Rizel S, et al. Long-term follow-up of chemotherapy-induced ovarian failure in young breast Cancer patients: the role of vascular toxicity. Oncologist. 2015;20(9):985–91.CrossRef Ben-Aharon I, Granot T, Meizner I, Hasky N, Tobar A, Rizel S, et al. Long-term follow-up of chemotherapy-induced ovarian failure in young breast Cancer patients: the role of vascular toxicity. Oncologist. 2015;20(9):985–91.CrossRef
5.
go back to reference Meirow D, Dor J, Kaufman B, Shrim A, Rabinovici J, Schiff E, et al. Cortical fibrosis and blood-vessels damage in human ovaries exposed to chemotherapy. Potential mechanisms of ovarian injury. Hum Reprod. 2007;22(6):1626–33.CrossRef Meirow D, Dor J, Kaufman B, Shrim A, Rabinovici J, Schiff E, et al. Cortical fibrosis and blood-vessels damage in human ovaries exposed to chemotherapy. Potential mechanisms of ovarian injury. Hum Reprod. 2007;22(6):1626–33.CrossRef
6.
go back to reference Letourneau JM, Ebbel EE, Katz PP, Katz A, Ai WZ, Chien AJ, et al. Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer. 2012;118(6):1710–7.CrossRef Letourneau JM, Ebbel EE, Katz PP, Katz A, Ai WZ, Chien AJ, et al. Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer. 2012;118(6):1710–7.CrossRef
7.
go back to reference Benedict C, Thom B, Friedman DN, Pottenger E, Raghunathan N, Kelvin JF. Fertility information needs and concerns post-treatment contribute to lowered quality of life among young adult female cancer survivors. Support Care Cancer. 2018;26(7):2209–15.CrossRef Benedict C, Thom B, Friedman DN, Pottenger E, Raghunathan N, Kelvin JF. Fertility information needs and concerns post-treatment contribute to lowered quality of life among young adult female cancer survivors. Support Care Cancer. 2018;26(7):2209–15.CrossRef
8.
go back to reference Diaz-Garcia C, Domingo J, Garcia-Velasco JA, Herraiz S, Mirabet V, Iniesta I, et al. Oocyte vitrification versus ovarian cortex transplantation in fertility preservation for adult women undergoing gonadotoxic treatments: a prospective cohort study. Fertil Steril. 2018;109(3):478.CrossRef Diaz-Garcia C, Domingo J, Garcia-Velasco JA, Herraiz S, Mirabet V, Iniesta I, et al. Oocyte vitrification versus ovarian cortex transplantation in fertility preservation for adult women undergoing gonadotoxic treatments: a prospective cohort study. Fertil Steril. 2018;109(3):478.CrossRef
9.
go back to reference Moravek MB, Confino R, Smith KN, Kazer RR, Klock SC, Lawson AK, et al. Long-term outcomes in cancer patients who did or did not pursue fertility preservation. Fertil Steril. 2018;109(2):349–55.CrossRef Moravek MB, Confino R, Smith KN, Kazer RR, Klock SC, Lawson AK, et al. Long-term outcomes in cancer patients who did or did not pursue fertility preservation. Fertil Steril. 2018;109(2):349–55.CrossRef
10.
go back to reference Donnez J, Dolmans MM, Pellicer A, Diaz-Garcia C, Sanchez Serrano M, Schmidt KT, et al. Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue: a review of 60 cases of reimplantation. Fertil Steril. 2013;99(6):1503–13.CrossRef Donnez J, Dolmans MM, Pellicer A, Diaz-Garcia C, Sanchez Serrano M, Schmidt KT, et al. Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue: a review of 60 cases of reimplantation. Fertil Steril. 2013;99(6):1503–13.CrossRef
11.
go back to reference Donnez J, Dolmans MM. Fertility preservation in women. N Engl J Med. 2017;377(17):1657–65.CrossRef Donnez J, Dolmans MM. Fertility preservation in women. N Engl J Med. 2017;377(17):1657–65.CrossRef
12.
go back to reference Dolmans MM, Marinescu C, Saussoy P, Van Langendonckt A, Amorim C, Donnez J. Reimplantation of cryopreserved ovarian tissue from patients with acute lymphoblastic leukemia is potentially unsafe. Blood. 2010;116(16):2908–14.CrossRef Dolmans MM, Marinescu C, Saussoy P, Van Langendonckt A, Amorim C, Donnez J. Reimplantation of cryopreserved ovarian tissue from patients with acute lymphoblastic leukemia is potentially unsafe. Blood. 2010;116(16):2908–14.CrossRef
13.
go back to reference Shaw JM, Bowles J, Koopman P, Wood EC, Trounson AO. Fresh and cryopreserved ovarian tissue samples from donors with lymphoma transmit the cancer to graft recipients. Hum Reprod. 1996;11(8):1668–73.CrossRef Shaw JM, Bowles J, Koopman P, Wood EC, Trounson AO. Fresh and cryopreserved ovarian tissue samples from donors with lymphoma transmit the cancer to graft recipients. Hum Reprod. 1996;11(8):1668–73.CrossRef
14.
go back to reference Chiti MC, Dolmans MM, Donnez J, Amorim CA. Fibrin in reproductive tissue engineering: a review on its application as a biomaterial for fertility preservation. Ann Biomed Eng. 2017;45(7):1650.CrossRef Chiti MC, Dolmans MM, Donnez J, Amorim CA. Fibrin in reproductive tissue engineering: a review on its application as a biomaterial for fertility preservation. Ann Biomed Eng. 2017;45(7):1650.CrossRef
15.
go back to reference Brännström M, Milenkovic M. Advances in fertility preservation for female cancer survivors. Nat Med. 2008;14(11):1182–4.CrossRef Brännström M, Milenkovic M. Advances in fertility preservation for female cancer survivors. Nat Med. 2008;14(11):1182–4.CrossRef
16.
go back to reference Xiao S, Zhang J, Romero MM, Smith KN, Shea LD, Woodruff TK. In vitro follicle growth supports human oocyte meiotic maturation. Sci Rep. 2015;5:17323.CrossRef Xiao S, Zhang J, Romero MM, Smith KN, Shea LD, Woodruff TK. In vitro follicle growth supports human oocyte meiotic maturation. Sci Rep. 2015;5:17323.CrossRef
17.
go back to reference McLaughlin M, Albertini DF, Wallace WHB, Anderson RA, Telfer EE. Metaphase II oocytes from human unilaminar follicles grown in a multi-step culture system. Mol Hum Reprod. 2018;24(3):135–42.CrossRef McLaughlin M, Albertini DF, Wallace WHB, Anderson RA, Telfer EE. Metaphase II oocytes from human unilaminar follicles grown in a multi-step culture system. Mol Hum Reprod. 2018;24(3):135–42.CrossRef
18.
go back to reference Luyckx V, Dolmans MM, Vanacker J, Legat C, Fortuno Moya C, Donnez J, et al. A new step toward the artificial ovary: survival and proliferation of isolated murine follicles after autologous transplantation in a fibrin scaffold. Fertil Steril. 2014;101(4):1149–56.CrossRef Luyckx V, Dolmans MM, Vanacker J, Legat C, Fortuno Moya C, Donnez J, et al. A new step toward the artificial ovary: survival and proliferation of isolated murine follicles after autologous transplantation in a fibrin scaffold. Fertil Steril. 2014;101(4):1149–56.CrossRef
19.
go back to reference Vanacker J, Luyckx V, Dolmans MM, Des Rieux A, Jaeger J, Van Langendonckt A, et al. Transplantation of an alginate-matrigel matrix containing isolated ovarian cells: first step in developing a biodegradable scaffold to transplant isolated preantral follicles and ovarian cells. Biomaterials. 2012;33(26):6079–85.CrossRef Vanacker J, Luyckx V, Dolmans MM, Des Rieux A, Jaeger J, Van Langendonckt A, et al. Transplantation of an alginate-matrigel matrix containing isolated ovarian cells: first step in developing a biodegradable scaffold to transplant isolated preantral follicles and ovarian cells. Biomaterials. 2012;33(26):6079–85.CrossRef
20.
go back to reference Shikanov A, Xu M, Woodruff TK, Shea LD. Interpenetrating fibrin-alginate matrices for in vitro ovarian follicle development. Biomaterials. 2009;30(29):5476–85.CrossRef Shikanov A, Xu M, Woodruff TK, Shea LD. Interpenetrating fibrin-alginate matrices for in vitro ovarian follicle development. Biomaterials. 2009;30(29):5476–85.CrossRef
21.
go back to reference West ER, Xu M, Woodruff TK, Shea LD. Physical properties of alginate hydrogels and their effects on in vitro follicle development. Biomaterials. 2007;28(30):4439–48.CrossRef West ER, Xu M, Woodruff TK, Shea LD. Physical properties of alginate hydrogels and their effects on in vitro follicle development. Biomaterials. 2007;28(30):4439–48.CrossRef
22.
go back to reference Luyckx V, Dolmans MM, Vanacker J, Scalercio SR, Donnez J, Amorim CA. First step in developing a 3D biodegradable fibrin scaffold for an artificial ovary. J Ovarian Res. 2013;6(1):83.CrossRef Luyckx V, Dolmans MM, Vanacker J, Scalercio SR, Donnez J, Amorim CA. First step in developing a 3D biodegradable fibrin scaffold for an artificial ovary. J Ovarian Res. 2013;6(1):83.CrossRef
23.
go back to reference Vanacker J, Dolmans MM, Luyckx V, Donnez J, Amorim CA. First transplantation of isolated murine follicles in alginate. Regen Med. 2014;9(5):609–19.CrossRef Vanacker J, Dolmans MM, Luyckx V, Donnez J, Amorim CA. First transplantation of isolated murine follicles in alginate. Regen Med. 2014;9(5):609–19.CrossRef
24.
go back to reference Xu M, Kreeger PK, Shea LD, Woodruff TK. Tissue-engineered follicles produce live, fertile offspring. Tissue Eng. 2006;12(10):2739–46.CrossRef Xu M, Kreeger PK, Shea LD, Woodruff TK. Tissue-engineered follicles produce live, fertile offspring. Tissue Eng. 2006;12(10):2739–46.CrossRef
25.
go back to reference Shikanov A, Smith RM, Xu M, Woodruff TK, Shea LD. Hydrogel network design using multifunctional macromers to coordinate tissue maturation in ovarian follicle culture. Biomaterials. 2011;32(10):2524–31.CrossRef Shikanov A, Smith RM, Xu M, Woodruff TK, Shea LD. Hydrogel network design using multifunctional macromers to coordinate tissue maturation in ovarian follicle culture. Biomaterials. 2011;32(10):2524–31.CrossRef
26.
go back to reference Laronda MM, Rutz AL, Xiao S, Whelan KA, Duncan FE, Roth EW, et al. A bioprosthetic ovary created using 3D printed microporous scaffolds restores ovarian function in sterilized mice. Nat Commun. 2017;8:15261.CrossRef Laronda MM, Rutz AL, Xiao S, Whelan KA, Duncan FE, Roth EW, et al. A bioprosthetic ovary created using 3D printed microporous scaffolds restores ovarian function in sterilized mice. Nat Commun. 2017;8:15261.CrossRef
27.
go back to reference Shea LD, Woodruff TK, Shikanov A. Bioengineering the ovarian follicle microenvironment. Annu Rev Biomed Eng. 2014;16:29–52.CrossRef Shea LD, Woodruff TK, Shikanov A. Bioengineering the ovarian follicle microenvironment. Annu Rev Biomed Eng. 2014;16:29–52.CrossRef
28.
go back to reference Hellström M, Bandstein S, Brännström M. Uterine tissue engineering and the future of uterus transplantation. Ann Biomed Eng. 2017;45(7):1718–30.CrossRef Hellström M, Bandstein S, Brännström M. Uterine tissue engineering and the future of uterus transplantation. Ann Biomed Eng. 2017;45(7):1718–30.CrossRef
29.
go back to reference Peloso A, Dhal A, Zambon JP, Li P, Orlando G, Atala A, et al. Current achievements and future perspectives in whole-organ bioengineering. Stem Cell Res Ther. 2015;6:107.CrossRef Peloso A, Dhal A, Zambon JP, Li P, Orlando G, Atala A, et al. Current achievements and future perspectives in whole-organ bioengineering. Stem Cell Res Ther. 2015;6:107.CrossRef
30.
go back to reference Reing JE, Zhang L, Myers-Irvin J, Cordero KE, Freytes DO, Heber-Katz E, et al. Degradation products of extracellular matrix affect cell migration and proliferation. Tissue Eng Part A. 2009;15(3):605–14.CrossRef Reing JE, Zhang L, Myers-Irvin J, Cordero KE, Freytes DO, Heber-Katz E, et al. Degradation products of extracellular matrix affect cell migration and proliferation. Tissue Eng Part A. 2009;15(3):605–14.CrossRef
31.
go back to reference Laronda MM, Jakus AE, Whelan KA, Wertheim JA, Shah RN, Woodruff TK. Initiation of puberty in mice following decellularized ovary transplant. Biomaterials. 2015;50:20–9.CrossRef Laronda MM, Jakus AE, Whelan KA, Wertheim JA, Shah RN, Woodruff TK. Initiation of puberty in mice following decellularized ovary transplant. Biomaterials. 2015;50:20–9.CrossRef
32.
go back to reference Liu WY, Lin SG, Zhuo RY, Xie YY, Pan W, Lin XF, et al. Xenogeneic Decellularized scaffold: a novel platform for ovary regeneration. Tissue Eng Part C Methods. 2017;23(2):61–71.CrossRef Liu WY, Lin SG, Zhuo RY, Xie YY, Pan W, Lin XF, et al. Xenogeneic Decellularized scaffold: a novel platform for ovary regeneration. Tissue Eng Part C Methods. 2017;23(2):61–71.CrossRef
33.
go back to reference Hassanpour A, Talaei-Khozani T, Kargar-Abarghouei E, Razban V, Vojdani Z. Decellularized human ovarian scaffold based on a sodium lauryl ester sulfate (SLES)-treated protocol, as a natural three-dimensional scaffold for construction of bioengineered ovaries. Stem Cell Res Ther. 2018;9(1):252.CrossRef Hassanpour A, Talaei-Khozani T, Kargar-Abarghouei E, Razban V, Vojdani Z. Decellularized human ovarian scaffold based on a sodium lauryl ester sulfate (SLES)-treated protocol, as a natural three-dimensional scaffold for construction of bioengineered ovaries. Stem Cell Res Ther. 2018;9(1):252.CrossRef
35.
go back to reference Oktay K, Bedoschi G, Pacheco F, Turan V, Emirdar V. First pregnancies, live birth, and in vitro fertilization outcomes after transplantation of frozen-banked ovarian tissue with a human extracellular matrix scaffold using robot-assisted minimally invasive surgery. Am J Obstet Gynecol. 2016;214(1):94.e1–9.CrossRef Oktay K, Bedoschi G, Pacheco F, Turan V, Emirdar V. First pregnancies, live birth, and in vitro fertilization outcomes after transplantation of frozen-banked ovarian tissue with a human extracellular matrix scaffold using robot-assisted minimally invasive surgery. Am J Obstet Gynecol. 2016;214(1):94.e1–9.CrossRef
36.
go back to reference Sadr SZ, Fatehi R, Maroufizadeh S, Amorim CA, Ebrahimi B. Utilizing fibrin-alginate and Matrigel-alginate for mouse follicle development in three-dimensional culture systems. Biopreserv Biobank. 2018;16(2):120–7.CrossRef Sadr SZ, Fatehi R, Maroufizadeh S, Amorim CA, Ebrahimi B. Utilizing fibrin-alginate and Matrigel-alginate for mouse follicle development in three-dimensional culture systems. Biopreserv Biobank. 2018;16(2):120–7.CrossRef
37.
go back to reference Poornejad N, Schaumann LB, Buckmiller EM, Momtahan N, Gassman JR, Ma HH, et al. The impact of decellularization agents on renal tissue extracellular matrix. J Biomater Appl. 2016;31(4):521–33.CrossRef Poornejad N, Schaumann LB, Buckmiller EM, Momtahan N, Gassman JR, Ma HH, et al. The impact of decellularization agents on renal tissue extracellular matrix. J Biomater Appl. 2016;31(4):521–33.CrossRef
38.
go back to reference Simsa R, Padma AM, Heher P, Hellstrom M, Teuschl A, Jenndahl L, et al. Systematic in vitro comparison of decellularization protocols for blood vessels. PLoS One. 2018;13(12):e0209269.CrossRef Simsa R, Padma AM, Heher P, Hellstrom M, Teuschl A, Jenndahl L, et al. Systematic in vitro comparison of decellularization protocols for blood vessels. PLoS One. 2018;13(12):e0209269.CrossRef
39.
go back to reference Hellström M, El-Akouri RR, Sihlbom C, Olsson BM, Lengqvist J, Bäckdahl H, et al. Towards the development of a bioengineered uterus: comparison of different protocols for rat uterus decellularization. Acta Biomater. 2014;10(12):5034–42.CrossRef Hellström M, El-Akouri RR, Sihlbom C, Olsson BM, Lengqvist J, Bäckdahl H, et al. Towards the development of a bioengineered uterus: comparison of different protocols for rat uterus decellularization. Acta Biomater. 2014;10(12):5034–42.CrossRef
40.
go back to reference Hellström M, Moreno-Moya JM, Bandstein S, Bom E, Akouri RR, Miyazaki K, et al. Bioengineered uterine tissue supports pregnancy in a rat model. Fertil Steril. 2016;106(2):487–96.e1.CrossRef Hellström M, Moreno-Moya JM, Bandstein S, Bom E, Akouri RR, Miyazaki K, et al. Bioengineered uterine tissue supports pregnancy in a rat model. Fertil Steril. 2016;106(2):487–96.e1.CrossRef
41.
go back to reference Meyer SR, Nagendran J, Desai LS, Rayat GR, Churchill TA, Anderson CC, et al. Decellularization reduces the immune response to aortic valve allografts in the rat. J Thorac Cardiovasc Surg. 2005;130(2):469–76.CrossRef Meyer SR, Nagendran J, Desai LS, Rayat GR, Churchill TA, Anderson CC, et al. Decellularization reduces the immune response to aortic valve allografts in the rat. J Thorac Cardiovasc Surg. 2005;130(2):469–76.CrossRef
42.
go back to reference Oktem O, Oktay K. The role of extracellular matrix and activin-a in in vitro growth and survival of murine preantral follicles. Reprod Sci. 2007;14(4):358–66.CrossRef Oktem O, Oktay K. The role of extracellular matrix and activin-a in in vitro growth and survival of murine preantral follicles. Reprod Sci. 2007;14(4):358–66.CrossRef
43.
go back to reference Oktay K, Karlikaya G, Akman O, Ojakian GK, Oktay M. Interaction of extracellular matrix and activin-a in the initiation of follicle growth in the mouse ovary. Biol Reprod. 2000;63(2):457–61.CrossRef Oktay K, Karlikaya G, Akman O, Ojakian GK, Oktay M. Interaction of extracellular matrix and activin-a in the initiation of follicle growth in the mouse ovary. Biol Reprod. 2000;63(2):457–61.CrossRef
44.
go back to reference Crapo PM, Gilbert TW, Badylak SF. An overview of tissue and whole organ decellularization processes. Biomaterials. 2011;32(12):3233–43.CrossRef Crapo PM, Gilbert TW, Badylak SF. An overview of tissue and whole organ decellularization processes. Biomaterials. 2011;32(12):3233–43.CrossRef
46.
go back to reference Sanders B, Driessen-Mol A, Bouten CVC, Baaijens FPT. The effects of scaffold remnants in Decellularized tissue-engineered cardiovascular constructs on the recruitment of blood cells<sup/>. Tissue Eng Part A. 2017;23(19–20):1142–51.CrossRef Sanders B, Driessen-Mol A, Bouten CVC, Baaijens FPT. The effects of scaffold remnants in Decellularized tissue-engineered cardiovascular constructs on the recruitment of blood cells<sup/>. Tissue Eng Part A. 2017;23(19–20):1142–51.CrossRef
Metadata
Title
Decellularization of the mouse ovary: comparison of different scaffold generation protocols for future ovarian bioengineering
Authors
Ahmed Baker Alshaikh
Arvind Manikantan Padma
Matilda Dehlin
Randa Akouri
Min Jong Song
Mats Brännström
Mats Hellström
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Fertility
Published in
Journal of Ovarian Research / Issue 1/2019
Electronic ISSN: 1757-2215
DOI
https://doi.org/10.1186/s13048-019-0531-3

Other articles of this Issue 1/2019

Journal of Ovarian Research 1/2019 Go to the issue