Ovarian tissue cryopreservation prior to cancer treatment: The Lis experience

Objective: Ovarian tissue cryopreservation (OTCP) is a new technology whose key goal is to create a bank of gametes in women. This new method has, however, not yet proven itself in the human species, and until now pregnancies have only been achieved in animals. The aim of this study is to present our clinical experience during the last two years. Design: Retrospective analysis. Materials/Methods: OTCP was performed in 36 patients aged 6–40 years. Only five were unmarried. The indications for OTCP included: breast cancer, osteosarcoma, Hodgkins disease, non-Hodjkin’s lymphoma, colon cancer, rectal cancer, borderline tumor of the ovary, and nephrotic syndrome. After laparoscopy, multiple ovarian biopsies were taken from the ovary in 27 patients, and total oophorectomy was performed in nine patients. Transposition of the other ovary was performed in five patients. Segments of ovarian cortical tissue, approximately 5x5 × 10 mm, were removed and cryopreserved. In those patients who underwent oophorectomy, dissection and slicing of the ovarian cortex was performed. All specimens were examined by the same pathohistologist for presence of metastases and counting the number of primordial follicles. In addition to the surgical procedure, gonadotropin releasing hormone analogue was prescribed during chemotherapy. Results: The laparoscopic procedure was uneventful in all but one patient. Three patients suffered from premature ovarian failure, and two patients suffered from prolonged amenorrhea. Examination of the ovarian cortex revealed highly significant inter-individual differences.Two patients died from metastatic primary disease. Three patients conceived spontaneously after the OTCP. Conclusions: The cryopreservation of ovarian tissue should be seriously considered for any patient undergoing treatment likely to impair future fertility; the indications being pelvic, extra-pelvic or systemic diseases. The age and the marital status of the patient should be considered prior to performing the procedure. Supported by: No support.