title: Recent advances in the field of ovarian tissue cryopreservation and opportunities for research.
abstract: OBJECTIVE
  The purpose of this study was to summarize the latest advances and successes in the field of ovarian tissue cryopreservation while identifying gaps in current knowledge that suggest opportunities for future research.
  
  
  METHODS
  A systematic review was performed according to PRISMA guidelines for all relevant full-text articles in PubMed published in English that reviewed or studied historical or current advancements in ovarian tissue cryopreservation and auto-transplantation techniques.
  
  
  RESULTS
  Ovarian tissue auto-transplantation in post-pubertal women is capable of restoring fertility with over 80 live births currently reported with a corresponding pregnancy rate of 23 to 37%. The recently reported successes of live births from transplants, both in orthotopic and heterotopic locations, as well as the emerging methods of in vitro maturation (IVM), in vitro culture of primordial follicles, and possibility of in vitro activation (IVA) suggest new fertility options for many women and girls. Vitrification, as an ovarian tissue cryopreservation technique, has also demonstrated successful live births and may be a more cost-effective method to freezing with less tissue injury. Further, transplantation via the artificial ovary with an extracellular tissue matrix (ECTM) scaffolding as well as the effects of sphingosine-1-phosphate (SIP) and fibrin modified with heparin-binding peptide (HBP), heparin, and a vascular endothelial growth factor (VEGF) have demonstrated important advancements in fertility preservation. As a fertility preservation method, ovarian tissue cryopreservation and auto-transplantation are currently considered experimental, but future research may pave the way for these modalities to become a standard of care for women facing the prospect of sterility from ovarian damage.
authors.affiliation: Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME, 04102, USA.
authors.forename: Camille
authors.initials: C
authors.lastname: Ladanyi
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, 11219, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Mor
authors.affiliation: Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
authors.forename: Mindy S
authors.initials: MS
authors.lastname: Christianson
authors.affiliation: University of Toledo College of Medicine, Toledo, OH, 43614, USA.
authors.forename: Namisha
authors.initials: N
authors.lastname: Dhillon
authors.affiliation: Howard W. and Georgeanna Seegar Jones Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 720 Rutland Ave, Ross Building (Room 624), Baltimore, MD, 21205, USA. jsegars2@jhmi.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Segars
mesh_terms: D015925:Cryopreservation / Q000639:trends*; D005260:Female; D005298:Fertility / Q000502:physiology*; D059247:Fertility Preservation; D006801:Humans; D050498:Live Birth; D006080:Ovarian Follicle / Q000254:growth & development / Q000378:metabolism*; D010053:Ovary / Q000254:growth & development / Q000378:metabolism*; D011247:Pregnancy; D058989:Vitrification
keywords: Auto-transplantation; Cancer; Fertility preservation; Ovarian cryopreservation; Ovarian insufficiency; Systematic review