title: Pregnancies and live births after 20 transplantations of cryopreserved ovarian tissue in a single center.
abstract: OBJECTIVE
  To report the results of 20 orthotopic retransplantations of cryopreserved ovarian tissue after cancer treatment.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Tertiary gynecology department.
  
  
  METHODS
  Twenty patients with malignant disease: 11 with hematological malignancies (55%), four with breast cancer (20%), three with anal cancer (15%), and two with ovarian cancer (10%); the mean age before oncological treatment was 30.5 years.
  
  
  METHODS
  Ovarian tissue was removed from patients in various centers in Germany in 2005-2009. All patients received chemotherapy and/or radiotherapy. Afterward, 17 patients had complete premature ovarian insufficiency, while three still showed some ovarian activity. Overnight transportation of tissue before freezing was necessary in eight cases. Cryopreservation followed slow freezing protocols in all cases. Retransplantation was performed at Erlangen University Hospital 3.75 years after extraction, on average. Thawed tissue was transplanted into a peritoneal pouch in the broad ligament region, below the tube, in 16 cases. Fragments were sutured both onto the remaining ovary and into a peritoneal pouch in four cases.
  
  
  METHODS
  Restoration of ovarian activity, pregnancy, birth.
  
  
  RESULTS
  Ovarian activity resumed in all patients except one. Seven patients conceived, with one miscarriage and four ongoing pregnancies. Four patients delivered healthy babies. One pregnancy and live birth after oocyte donation need to be considered separately.
  
  
  CONCLUSIONS
  These data clearly demonstrate that preserving fertility by cryopreserving ovarian tissue is a successful and safe clinical option that can be considered for selected cancer patients.
authors.affiliation: Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany. Electronic address: ralf.dittrich@uk-erlangen.de.
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.affiliation: Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Janina
authors.initials: J
authors.lastname: Hackl
authors.affiliation: Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Lotz
authors.affiliation: Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Inge
authors.initials: I
authors.lastname: Hoffmann
authors.affiliation: Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
mesh_terms: D000328:Adult; D015925:Cryopreservation / Q000379:methods* / Q000639:trends; D005260:Female; D059247:Fertility Preservation / Q000379:methods* / Q000639:trends; D005500:Follow-Up Studies; D006801:Humans; D050498:Live Birth / Q000453:epidemiology*; D009369:Neoplasms / Q000453:epidemiology / Q000601:surgery; D010053:Ovary / Q000601:surgery / Q000637:transplantation*; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods* / Q000639:trends; D014182:Transplantation, Autologous / Q000379:methods; D055815:Young Adult
keywords: Fertility preservation; cryopreserved ovarian tissue; live birth; pregnancy; transplantation