Ovarian cryopreservation and transplantation for fertility preservation for medical indications: report of an ongoing experience.
OBJECTIVE
To assess the indications, safety, utilization, and success of ovarian tissue freezing and transplantation.


METHODS
Prospective longitudinal analysis.


METHODS
Academic medical centers.


METHODS
Fifty-nine women who underwent ovarian tissue cryopreservation with a slow freezing technique between May 1997 and March 2008. A follow-up was conducted 36.8 +/- 3.6 months after the procedure.


METHODS
Ovarian tissue harvesting and cryopreservation.


METHODS
Indications, safety, and utilization rates.


RESULTS
The mean age (+/- SE) was 26.7 +/-1.2 years (range 4-44 years). The majority of patients had either hematologic malignancies (45.7%) or breast cancer (22%). Of these, 57.6% underwent hematopoietic stem cell transplantation. No complications occurred and no histologic evidence of cancer was found in the harvested tissue. The median length of storage was 3.5 +/- 0.3 years (0.06-10.5 years). Fifty-six of 59 patients have not yet used their ovarian tissue. The reasons for nonutilization were social/personal, being still under treatment, and death in 54%, 38%, and 8%, respectively. Only three women (5.1%) underwent transplantation, two with the heterotopic (abdominal wall) and one with the orthotopic technique. One woman with a heterotopic transplant conceived spontaneously and delivered. Of the three transplants, one ceased function after 9 months and two are still functioning at up to 7 years follow-up.


CONCLUSIONS
Ovarian tissue harvesting appears to be safe but the experience with ovarian transplantation is still limited due to low utilization. As a result, the true value of this procedure remains to be determined.
Oktay
Kutluk
K
Department of Obstetrics and Gynecology, New York Medical College, Valhalla, New York and Institute for Fertility Preservation, Center for Human Reproduction, New York, New York 10021, USA. koktay@fertilitypreservation.org
Oktem
Ozgur
O
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D004715:Endometriosis / Q000150:complications / Q000453:epidemiology; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D008137:Longitudinal Studies; D009865:Oocytes / Q000166:cytology* / Q000637:transplantation*; D016649:Primary Ovarian Insufficiency / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D020858:Tissue and Organ Harvesting; D055815:Young Adult
D000970:Antineoplastic Agents