Optimizing outcomes from ovarian tissue cryopreservation and transplantation; activation versus preservation.
Ovarian tissue cryopreservation and transplantation (OTCP) is gaining increasing traction in the field of fertility preservation as a result of accumulated successes. We now have a decade of experience with the technique, with tens of live births and greater than 90% return of ovarian function in graft recipients. Recently, a novel method of OTCP has been described, termed in vitro activated OTCP which proposes significant changes to the standard protocol. This method aims to stimulate activation of dormant follicles within the grafts prior to transplantation and ensure that mature oocytes can be generated in the immediate short term after transplantation. By contrast, conventional OTCP seeks to maintain dormancy and thus preserve the follicle reserve in the graft with the aim of maximizing graft lifespan. This opinion paper will compare the two methods of OTCP, highlighting their respective advantages and disadvantages, and provide suggestions as to when to apply either one of these methods in a clinical setting.
Center for Fertility Preservation, IVF Unit, Sheba Medical Center, Tel Hashomer, Israel meirow@post.tau.ac.il.
Dror
D
Meirow
Center for Fertility Preservation, IVF Unit, Sheba Medical Center, Tel Hashomer, Israel.
Hadassa
H
Roness
Laboratory of Reproductive Biology, University Hospital Copenhagen, University of Copenhagen, Copenhagen, Denmark.
Stine Gry
SG
Kristensen
Laboratory of Reproductive Biology, University Hospital Copenhagen, University of Copenhagen, Copenhagen, Denmark.
Claus Yding
CY
Andersen
D015925:Cryopreservation / Q000379:methods* / Q000592:standards; D005260:Female; D059247:Fertility Preservation / Q000379:methods* / Q000592:standards; D006801:Humans; D017063:Outcome Assessment, Health Care; D010053:Ovary / Q000502:physiology* / Q000601:surgery; D016378:Tissue Transplantation / Q000379:methods* / Q000592:standards
fertility preservation; follicle activation; ovarian tissue cryopreservation; ovarian tissue transplantation