Long-term ovarian function and fertility after heterotopic autotransplantation of cryobanked human ovarian tissue: 8-year experience in cancer patients.
OBJECTIVE
To assess the long-term ovarian function and fertility after heterotopic autotransplantation of frozen-thawed ovarian tissue in cancer patients.


METHODS
Prospective clinical case series.


METHODS
Academic medical center


METHODS
Four young cancer patients who completed cancer treatment.


METHODS
Cryopreserved ovarian tissue (2000-2002) was thawed and transplanted to the heterotopic site (between the rectus muscle and fascia) between 2002 and 2005.


METHODS
[1] Serial blood tests (FSH, LH, estradiol, progesterone, testosterone) and ultrasound examinations. [2] Oocyte retrieval and in vitro fertilization.


RESULTS
The hormonal profiles were consistent with the postmenopausal level before transplantation. The return of the ovarian function was evidenced by hormonal profiles between 12 and 20 weeks after transplantation. Three patients underwent a second transplantation, as restored ovarian function lasted only 3 to 5 months. After the second transplantation, long-term ovarian function (lasting for 15-41 months) was established in all three patients. Six oocytes (one GV, four MI, one MII) were retrieved from the grafts. Three MI oocytes were developed to full maturity in vitro. Four MII oocytes were fertilized and developed to the cleavage stage embryos (up to six-cell).


CONCLUSIONS
Autotransplantation of frozen-thawed ovarian tissue to a heterotopic site restored long-term ovarian function (for >40 months), and showed a potential to restore fertility in cancer patients.
Kim
S Samuel
SS
Reproductive Endocrinology & Infertility, University of Kansas, Kansas City, Kansas 66160, USA. skim2@kumc.edu
Lee
Woo S
WS
Chung
Mi K
MK
Lee
Hoi Chang
HC
Lee
Hyang H
HH
Hill
David
D
D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D015925:Cryopreservation; D004958:Estradiol / Q000097:blood; D005260:Female; D005298:Fertility; D005306:Fertilization; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D054315:Oocyte Retrieval / Q000379:methods; D009924:Organ Culture Techniques; D010053:Ovary / Q000502:physiology* / Q000637:transplantation*; D010062:Ovulation Induction / Q000379:methods; D020554:Sperm Injections, Intracytoplasmic; D014182:Transplantation, Autologous / Q000379:methods*; D016042:Transplantation, Heterotopic / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000601:surgery
D004958:Estradiol; D005640:Follicle Stimulating Hormone