Laparoscopic ovarian tissue preservation in young patients at risk for ovarian failure as a result of chemotherapy/irradiation for primary malignancy

Abstract

Background: Aggressive chemotherapy/radiotherapy for cancer may cause gonadal failure in young female survivors. The putative aim of ovarian tissue cryopreservation is to restore fertility by transplantation of a patient's frozen-thawed ovarian tissue or, further into the future, by in vitro maturation of frozen-thawed oocytes followed by in vitro fertilization. This report presents our early experience with ovarian tissue preservation in young patients.

Methods: We conducted a database review of the techniques and outcomes of the ethics board-approved ovarian tissue cryopreservation procedures performed at our center since 1998 for young girls with malignancy.

Results: The study group included 23 patients (median age = 14 years) with various types of cancer (hematologic, bone, ovarian, or intracranial); 11 patients were scheduled for chemotherapy, 11 patients had already undergone some form of chemotherapy before the ovarian tissue harvesting, and 1 patient was not scheduled for chemotherapy. Ten underwent bone marrow transplantation after tissue retrieval. Twenty-one patients underwent laparoscopic harvesting of their ovarian tissue. In the other 2 patients, the ovary was preserved during inguinal hernia repair or tissue was obtained at laparotomy for a pelvic tumor. All patients had benign operative and postoperative courses.

Conclusions: Laparoscopy for ovarian tissue retrieval for cryopreservation is safe in young cancer patients. Based on reports of successful cryopreservation of human ovarian tissue containing primordial follicles, we believe that this approach holds promise for female cancer survivors.