Cryopreservation and transplantation of ovary tissue: results from one center in the united states

Abstract

To report the first series in the United States of cryopreserved ovary tissue transplantation using slow freeze or vitrification, for leukemia and other cancers. 13 patients over a 10 year period underwent thaw and transplantation of ovarian tissue that had been cryopreserved up to 20 years earlier when they were 20 years of age or younger. A single fertility center in a community hospital in the United states with a single team over 20 years. 108 females between age 6 and 35 were referred for possible ovary tissue cryopreservation over a 20 year period. Before 10 years ago only slow freeze was utilized, and after that only vitrification. Thus far only 13 patients whose tissue was frozen prior to age 35 returned up to 20 years later to have their tissue transplanted back, and have more than 2 years of post-transplant follow-up. No other ancillary treatment was administered. Detailed follow of hormones, menstruation, pregnancies, and live birth. All 13 cases 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. 4 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 (85%) became spontaneously pregnant at least one, resulting in 13 healthy babies. Ovarian tissue cryopreservation and transplantation in young patients is a robust method of fertility preservation. Cortical tissue pressure may be a key regulator of primordial follicle recruitment and ovarian longevity.