Chapter 30 - Autologous Transplantation of Human Ovarian Tissue

Abstract

First reported in 2000, autologous transplantation of frozen-thawed human ovarian tissue is one of the remarkable achievements in modern reproductive surgery. This advanced procedure is currently the only practical option for fertility preservation in girls of prepubertal age, as well as the reproductive age women who cannot delay initiation of potentially gonadotoxic therapies for oncological or nononcological diseases. Numerous antineoplastic treatments and radiotherapy cause irreversible loss of ovarian reserve leading to premature ovarian failure and infertility. Cryopreservation of ovarian tissue enables preservation of a population of primordial follicles embedded in ovarian cortex before such gonadotoxic treatments and offers a chance for maintaining reproductive potential. Once the treatments are completed and the patient is cured of her disease, endocrine function and fertility can be restored upon autotransplantation. In this chapter, we describe the concept of ovarian tissue cryopreservation and reimplantation starting with a brief history of its development. In the following sections, we present the current approaches, discuss current limitations, and conclude with future directions.