alexa Ovarian cryopreservation and transplantation for fertility preservation for medical indications: report of an ongoing experience.
Reproductive Medicine

Reproductive Medicine

Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biology

Author(s): Oktay K, Oktem O

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Abstract OBJECTIVE: To assess the indications, safety, utilization, and success of ovarian tissue freezing and transplantation. DESIGN: Prospective longitudinal analysis. SETTING: Academic medical centers. PATIENT(S): Fifty-nine women who underwent ovarian tissue cryopreservation with a slow freezing technique between May 1997 and March 2008. A follow-up was conducted 36.8 +/- 3.6 months after the procedure. INTERVENTION(S): Ovarian tissue harvesting and cryopreservation. MAIN OUTCOME MEASURE(S): Indications, safety, and utilization rates. RESULT(S): The mean age (+/- SE) was 26.7 +/-1.2 years (range 4-44 years). The majority of patients had either hematologic malignancies (45.7\%) or breast cancer (22\%). Of these, 57.6\% underwent hematopoietic stem cell transplantation. No complications occurred and no histologic evidence of cancer was found in the harvested tissue. The median length of storage was 3.5 +/- 0.3 years (0.06-10.5 years). Fifty-six of 59 patients have not yet used their ovarian tissue. The reasons for nonutilization were social/personal, being still under treatment, and death in 54\%, 38\%, and 8\%, respectively. Only three women (5.1\%) underwent transplantation, two with the heterotopic (abdominal wall) and one with the orthotopic technique. One woman with a heterotopic transplant conceived spontaneously and delivered. Of the three transplants, one ceased function after 9 months and two are still functioning at up to 7 years follow-up. CONCLUSION(S): Ovarian tissue harvesting appears to be safe but the experience with ovarian transplantation is still limited due to low utilization. As a result, the true value of this procedure remains to be determined. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved. This article was published in Fertil Steril and referenced in Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biology

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