Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue a review of 60 cases of reimplantation

Capsule:
A review of 60 cases of frozen-thawed ovarian tissue reimplantation is presented. Cryopreservation of ovarian tissue is the only option available for prepubertal girls and for women who cannot delay the start of chemotherapy.

Authors:
Jacques Donnez, M.D., Ph.D., Marie-Madeleine Dolmans, M.D., Ph.D., Antonio Pellicer, M.D., Ph.D., Cesar Diaz-Garcia, Maria Sanchez Serrano, M.D., K.T. Schmidt, M.D., E. Ernst, M.D., Valérie Luyckx, M.D., Claus Yding Andersen, M.D.Sc.

Volume 99, Issue 6, Pages 1503-1513, May 2013

Abstract:

Aggressive chemotherapy and radiotherapy, and bone marrow transplantation (BMT), can cure >90% of girls and young women affected by disorders requiring such treatment. However, the ovaries are very sensitive to cytotoxic drugs, especially to alkylating agents. Several options are currently available to preserve fertility in cancer patients. This present review reports the results of 60 orthotopic reimplantations of cryopreserved ovarian tissue as well as the 24 live births so far reported in the literature. Restoration of ovarian activity occurred in nearly all cases. Among the 60 patients, 11 were pregnant and 6 of them already delivered 12 healthy babies. In the future, we should pay attention: 1) to improve the freezing techniques; 2) to favor the “vascular bed” before reimplantation, in order to increase the pregnancy rate. On the other hand, freezing of ovarian tissue may be combined with removal, via puncture, of small antral follicles making it possible to freeze ovarian tissue and isolate immature oocytes.

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