Techniques for ovarian tissue transplantation and results

Abstract

Fertility preservation has emerged as a field of growing interest thanks to increasingly effective cancer treatments in women. For young women with good prospects of surviving cancer, fertility preservation counseling before gonadotoxic treatment is imperative to offer them a potential chance of future childbearing. Ovarian tissue cryopreservation and transplantation emerges as a strategy for fertility preservation, especially for prepubertal girls, adolescents and women in whom cancer treatment cannot be delayed. Numerous surgical techniques have been reported and are currently being used for frozen-thawed ovarian tissue reimplantation, but successful approaches all adhere to the same fundamental micro-surgical principles: 1) finding a well vascularized orthotopic transplantation site, and 2) fixing the ovarian tissue by means of stitches, Interceed® and/or fibrin glue. Orthotopic reimplantation has proved to be the most effective technique in terms of resumption of ovarian endocrine function in more than 95% of all reported cases, and fertility restoration in over than 40% of patients in our series.