title: Long-term ovarian function and fertility after heterotopic autotransplantation of cryobanked human ovarian tissue: 8-year experience in cancer patients.
abstract: 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.
authors.affiliation: Reproductive Endocrinology & Infertility, University of Kansas, Kansas City, Kansas 66160, USA. skim2@kumc.edu
authors.forename: S Samuel
authors.initials: SS
authors.lastname: Kim
authors.forename: Woo S
authors.initials: WS
authors.lastname: Lee
authors.forename: Mi K
authors.initials: MK
authors.lastname: Chung
authors.forename: Hoi Chang
authors.initials: HC
authors.lastname: Lee
authors.forename: Hyang H
authors.initials: HH
authors.lastname: Lee
authors.forename: David
authors.initials: D
authors.lastname: Hill
mesh_terms: 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
chemical_list: D004958:Estradiol; D005640:Follicle Stimulating Hormone