Modern methods of fertility preservation: a tribute to Roger Gosden

Abstract

As a practitioner of ‘translational’ research, Roger Gosden’s contributions have been immense. Over a career spanning four decades, he has published numerous influential articles in peerreviewed journals and books dealing with the fertility and fecundity of various mammalian species from mouse to (wo)man. His focus has ranged from the basic biology of ovarian development and aging through gonadal preservation and growth in vitro, to human tissue transplantation: all towards improving quality of life and reproductive health. It was therefore entirely appropriate that the XVth Workshop ‘Development and Function of Reproductive Organs’ should honour Roger with an entire ‘festschrift’ session celebrating his work. This issue of MHR contains three peer-reviewed ‘New Research Horizon review’ articles arising out of the Gosden session, set together with two original research articles relating to the same topic. Each connects directly with Roger’s own research interests or personal contribution to the field. Silber begins by celebrating Roger’s fascination with ovarian transplantation through an elegant assessment of how the procedure has developed over the last half century, from exploratory animal experiment to successful clinical application. Modern tissue cryopreservation and surgical techniques mean that it is now entirely realistic for ovarian tissue to be removed, stored (so far, for up to 14 years) and donated such that recipients can now expect routinely to reinitiate normal ovulatory menstrual cycles within four months. Roger’s interests extend beyond the ovary, which is why the series also benefits from the Diaz-Garcia et al. article on uterine transplantation. Findings from experimental animal studies emphasise the technical challenges presented by organ retrieval and ischemic preservation; also the problems around achieving satisfactory anastomosis and immunosuppression to avoid tissue rejection by the donor. The procedure also poses unique ethical and legal challenges that would have to be accommodated were it ever to be applied clinically.