To transplant or not to transplant - That is the question

Abstract

Thousands of human ovaries have been stored for desperate cancer patients by practitioners around the world. Unfortunately, most of these ovaries were stored without a clear idea about how they could be used by the eventual survivor. Recent advances in ovarian tissue freezing and transplant technology and in the emerging area of in vitro follicle growth provide the opportunities the patients and providers were banking on. In this chapter, we review the state of the art of ovarian tissue transplantation and identify where transplant is advisable (many of the cases) and conditions where transplant is ill advised (e.g., ovarian malignancy, BRCA gene mutation, metastatic disease). In vitro follicle maturation has now succeeded in pre-clinical models but has not yet been attempted in the human. These follicle maturation strategies are reviewed with their technical and utilization limitations, and a discussion of the next steps that will proceed the first attempt at fertilization of an in vitro matured human follicle with egg maturation and embryo transfer will be provided. © 2010 Springer Science+Business Media, LLC.