A laparoscopic technique for obtaining ovarian cortical biopsy specimens for fertility conservation in patients with cancer

Abstract

Objective: To evaluate the efficacy of a newly designed round biopter as a practical and safe method for collecting ovarian tissue for cryopreservation in young women with cancer before chemotherapy. Design: Prospective study of young women volunteering for research (Leeds, United Kingdom) and patients with cancer (Jerusalem, Israel and Leeds, United Kingdom) undergoing laparoscopic ovarian cortical tissue biopsy and cryopreservation before administration of high-dose radiochemotherapy. Setting: Two university-based tertiary referral centers of oncology and gynecology (Hadassah Medical Center, Israel; Leeds General Infirmary, United Kingdom). Patient(s): Twenty female volunteers undergoing routine laparoscopic gynecologic procedures (age, 25–34 years) and 20 young women (age, 11–30 years) with advanced cancer requiring potentially sterilizing radiochemotherapy. Intervention(s): Cortical ovarian tissue biopsies performed under laparoscopy with use of the round biopter. Result(s): The laparoscopic sampling procedure was uncomplicated in all cases. In treated patients, five to six samples were obtained (5 mm in diameter; 2–3 mm in depth) using the round biopter, and radiochemotherapy was administered without delay. In volunteers, no adhesions were noted at repeat laparoscopy (9 patients). All biopsy specimens were cryopreserved, and histologic examination confirmed the presence of many primordial follicles. Conclusion(s): Laparoscopic ovarian biopsy performed with the round biopter is a safe and efficient method for collecting ovarian tissue for cryopreservation in patients with cancer.