Fertility preservation in cancer patients using stored ovarian tissue: clinical aspects.
OBJECTIVE
This review covers the medical approach and laboratory guidelines needed for fertility preservation using stored ovarian tissue in cancer patients. Indications, careful patient selection and timing are essential. Techniques for tissue harvesting and storage are evaluated. Up-to-date information on publications reporting on transplantation, recovery of endocrine function, pregnancy and delivery of healthy babies is reviewed as well as relevant data on safety measures to detect cancer cells in stored ovarian tissue.


RESULTS
Recent literature review indicates 12 pregnancies, five deliveries of healthy babies and two ongoing pregnancies after transplantation of ovarian tissue using different methods. To increase the safety of ovarian tissue cryopreservation-reimplantation procedures, algorithm and methods to identify tumor involvement in the ovaries and detection of small numbers of cancer cells in ovarian tissue were recently reported.


CONCLUSIONS
Cryopreservation of ovarian tissue has been practiced for over a decade in an attempt to preserve fertility before the commencement of potentially sterilizing chemotherapy. With more than a few recent reports on pregnancies and deliveries after transplantation of ovarian tissue, there will be more patients requesting the storage of ovarian tissue in order to preserve fertility prior to cancer treatments.
Meirow
Dror
D
IVF Unit, Division of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel. meirow@post.tau.ac.il
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002985:Clinical Protocols; D015925:Cryopreservation / Q000639:trends*; D005260:Female; D005298:Fertility / Q000187:drug effects / Q000528:radiation effects; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D009926:Organ Preservation / Q000639:trends*; D010053:Ovary; D011878:Radiotherapy / Q000009:adverse effects; D027724:Reproductive Techniques, Assisted; D014015:Tissue Banks / Q000600:supply & distribution