"Forever fertile": ovarian tissue cryopreservation for an extended reproductive lifespan

Abstract

The global decline in birth rates highlights the need for effective fertility preservation strategies. Even though oocyte cryopreservation is a well-established technique in cancer patients and is increasingly requested for elective fertility preservation, its success is limited by age at freezing and restoration of ovarian activity is not provided. Ovarian tissue cryopreservation is emerging as a promising alternative for both fertility preservation and reproductive lifespan extension. Unlike oocyte cryopreservation, ovarian tissue cryopreservation restores endocrine function, potentially delaying menopause and reducing associated health risks. Although concerns exist regarding graft longevity and surgical invasiveness, recent advancements-such as improved cryopreservation techniques, neovascularization strategies, and minimally invasive approaches-enhance its feasibility. Additionally, ovarian tissue cryopreservation allows for spontaneous conception, reducing the need for assisted reproductive technologies. As demand for reproductive longevity increases, the medical community must address ethical and regulatory implications while refining clinical applications. Integrating ovarian tissue cryopreservation into elective fertility preservation can provide women with more reproductive choices, aligning with advances in longevity medicine. Future research should focus on optimizing graft survival and assessing long-term health outcomes of delayed menopause to fully unlock the potential of ovarian tissue cryopreservation.

Keywords: Fertility; Menopause; Ovarian activity; Ovarian tissue cryopreservation; Pregnancy.