Ovarian tissue cryopreservation and transplantation

Abstract

While controlled ovarian hyperstimulation followed by IVF and cryopreservation of embryos is the most common and successful approach to fertility preservation for reproductive-age females diagnosed with cancer, there are many cases in which this approach may not be appropriate or possible. For some patients, a delay in cancer treatment for hormone treatment and egg retrieval is not acceptable, for others, hormone treatment may be contraindicated (e.g., for prepubertal patients and those with hormone-sensitive cancers), or they may not have a partner or willing sperm donor. Still other patients may have religious or moral objections to creating embryos. For these patients, ovarian tissue cryopreservation is an alternative option that does not require ovarian hyperstimulation or sperm. Cryopreserved tissue may be retransplanted into the patient at a later date to recover endocrine function and/or restore fertility. This chapter discusses the techniques required for ovarian tissue removal, cryopreservation, and transplantation and reviews current literature on outcomes of these procedures. While ovarian tissue cryopreservation and transplantation are considered experimental approaches, they are the only option for certain patients and need to be included in discussions about fertility preservation.