Abstract

To evaluate the use of cryopreserved ovarian tissue in the Danish fertility preservation cohort. Retrospective cohort study. University hospitals and fertility clinics. Ovarian tissue cryopreservation (OTC) was performed for 1,186 Danish girls and women from 1999-2020, of whom 117 subsequently underwent ovarian tissue transplantation (OTT). Subgroup 1 included 759 patients with a follow-up period of >5 years. Out of these, OTT rates were further analyzed for those patients who were alive and aged >24 years in July 2020 (subgroup 2; n = 554). OTC and OTT. OTT, death, donation of tissue. In subgroup 1, 14% of the patients had undergone OTT, 18% had died, 9% had donated their tissue for research, and 59% still had their tissue stored. In subgroup 2, 19% had undergone OTT and for most diagnoses the OTT rates ranged from 15% to 22% with benign hematologic diseases having the highest OTT rate (35%). On the basis of the entire cohort, stratified age analysis indicated that women aged ≥30 years at OTC were more likely to return for OTT than women aged 18-29 years at OTC; mean storage times were 3.7 and 3.6 years, respectively. Only 4% of the girls aged <18 years at OTC had undergone OTT. The OTT rates depended on the diagnosis, age at OTC, and follow-up time. Specific criteria are needed for reporting and comparing OTT rates. Six out of 10 patients still had their cryopreserved tissue stored and longer follow-up is needed, especially for younger girls.

Highlights

  • The return rates for ovarian tissue transplantation (OTT) in the Danish cohort are the highest reported to date

  • Our findings showed that the OTT rates were comparable for most of the diagnoses when it was based on the number of surviving patients aged >24 years with >5 years of follow-up

  • The return rate for OTT among women in the Danish cohort is the highest reported to date, and almost one in five patients who reached an age at which childbearing becomes of interest returned for OTT

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Summary

Methods

The study population included all 1,186 girls and women undergoing OTC for fertility preservation from 1999 to 2020 at the Laboratory of Reproductive Biology in Copenhagen, Denmark. All patients consented to OTC and underwent unilateral oophorectomy at one of the three referring hospitals in Denmark (Aarhus University Hospital, Copenhagen University Hospital, and Odense University Hospital). Ovarian tissue cryopreservation for fertility preservation was approved by the Ministry of Health in Denmark J/KF/01/170/99) and is considered a standard treatment. The slow-freezing procedure was performed in all cases with a consistently high follicular survival [18, 19].

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