Abstract
PurposeTo report the results of cryopreserved ovary tissue transplantation for leukemia and other cancers, in a single US center.MethodsOne hundred eight females between age 6 and (median age 24) 35 were referred for possible ovary tissue cryopreservation over a 20-year period, with either slow freeze or vitrification. Thus far 13 patients returned up to 18 years later to have their tissue transplanted back.ResultsAll 13 patients had return of ovarian function 5 months post transplant with regular menstrual cycling. AMH rose to very high levels as the FSH declined to normal. Four months later, the AMH again declined to very low levels. Nonetheless, the grafts remained functional for up to 5 years or longer. Ten of the 13 (77%) became spontaneously pregnant at least once, resulting in 13 healthy babies. A total of 24 healthy babies have been born 11 from fresh transplanted ovarian tissue and 13 from cryopreserved transplanted ovarian tissue.Conclusions(1) Ovary tissue cryopreservation is a robust method for preserving a woman’s fertility. (2) Cortical tissue pressure may be a key regulator of primordial follicle arrest, recruitment, and ovarian longevity. (3) This is the only such series yet reported in the USA.
Highlights
A series of 108 cases of ovary tissue cryopreservation initiated in 1997 gave us an opportunity to assess its efficiency for young women about to undergo sterilizing cancer treatment [1, 2]
Sixty-six were for cancer, 5 for threatened premature ovarian failure, 9 for social reasons, and 12 for a variety of conditions including Turner’s syndrome, multiple sclerosis, endometriosis, aplastic anemia, a daughter born with no ovary, or massive bilateral ovarian teratoma
All 13 cases had return of ovarian function from 4 to 5 months after transplantation, as determined by return of FSH to normal levels, and regular menstrual cycling, similar to what was previously reported with fresh ovary tissue transplantation
Summary
A series of 108 cases of ovary tissue cryopreservation initiated in 1997 gave us an opportunity to assess its efficiency for young women about to undergo sterilizing cancer treatment [1, 2]. Interest in cryopreserved ovarian cortical transplantation is rapidly growing, but systematic reports have been published from only a few centers [8]. Despite this great interest, there is a paucity of consistent series (none from the USA) reported from one center in which the expectation of success rate for this procedure can be gleaned [27,28,29]
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