Duration of fertility after fresh and frozen ovary transplantation.
OBJECTIVE
To evaluate the function of human ovarian transplants.


METHODS
Follow a series of fresh ovarian transplants for up to 5 years, and compare fresh and frozen ovarian tissue transplantation.


METHODS
Tertiary referral community hospital.


METHODS
Nine women with premature ovarian failure who received an ovary donated from a monozygotic twin sibling, and 16 young cancer patients undergoing ovarian cryopreservation. Two of the transplant recipients were cancer survivors rendered sterile by their therapy.


METHODS
Fresh ovary transplantation between monozygotic twin sisters, as well as transplantation of previously frozen ovarian tissue, and study of cryopreserved tissue in cancer patients.


METHODS
Return of normal menstrual cycling, hormone levels, pregnancy, healthy babies, duration of transplant function, and ovarian tissue evaluation.


RESULTS
Normal serum FSH and regular menstrual cycles returned by 5 months after surgery in all cases, both fresh and frozen. Fourteen spontaneous pregnancies were established leading to eight healthy live births and two healthy ongoing conceptions. All three frozen tissue transplants conceived spontaneously, one delivered, and two were ongoing. Oocyte survival with slow freezing was 42% and after vitrification 89%.


CONCLUSIONS
Ovarian transplantation in humans is a robust procedure, even after cryopreservation, and vitrification might prove to be more effective than slow freezing.
Silber
Sherman
S
Infertility Center of St. Louis, St. Luke's Hospital, St. Louis, Missouri, USA. silber@infertile.com
Kagawa
Nori
N
Kuwayama
Masashige
M
Gosden
Roger
R
D000328:Adult; D004200:Diseases in Twins / Q000534:rehabilitation / Q000601:surgery; D005260:Female; D005298:Fertility / Q000502:physiology*; D005500:Follow-Up Studies; D005615:Freezing; D013509:Gynecologic Surgical Procedures / Q000534:rehabilitation*; D006801:Humans; D007247:Infertility, Female / Q000534:rehabilitation* / Q000601:surgery*; D050498:Live Birth / Q000453:epidemiology; D008593:Menopause / Q000502:physiology; D010053:Ovary / Q000502:physiology / Q000601:surgery / Q000637:transplantation*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D018873:Pregnancy Rate; D013997:Time Factors; D055815:Young Adult