Ovarian tissue cryopreservation and transplantation in cancer patients

Best Pract Res Clin Obstet Gynaecol. 2010 Feb;24(1):87-100. doi: 10.1016/j.bpobgyn.2009.09.003. Epub 2009 Oct 21.

Abstract

Advances in the diagnosis and treatment of childhood, adolescent and adult cancer have greatly increased the life expectancy of premenopausal women with cancer. The ovaries are very sensitive to cytotoxic treatment, especially to alkylating agents. The only established method of fertility preservation is embryo cryopreservation according to the Ethics Committee of the American Society for Reproductive Medicine (2005), but this option requires the patient to be of pubertal age, have a partner or use donor sperm and be able to undergo a cycle of ovarian stimulation, which is not possible when the chemotherapy has to be initiated immediately or when stimulation is contraindicated, according to the type of cancer. For patients who need immediate chemotherapy, cryopreservation of ovarian tissue is the only possible alternative. This article reports the techniques and results of orthotopic transplantation of cryopreserved ovarian tissue. Among almost 30 cases reported in the literature, six live births have been achieved to date.

MeSH terms

  • Adult
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Cryopreservation* / methods
  • Embryo Transfer*
  • Evidence-Based Medicine
  • Female
  • Fertilization in Vitro*
  • Humans
  • Infertility, Female / chemically induced
  • Infertility, Female / prevention & control*
  • Oocytes / transplantation
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / therapy
  • Ovary / transplantation*
  • Ovulation Induction / methods
  • Practice Guidelines as Topic
  • Pregnancy
  • Primary Ovarian Insufficiency / chemically induced
  • Primary Ovarian Insufficiency / prevention & control
  • Replantation
  • Risk Assessment
  • Risk Factors

Substances

  • Antineoplastic Agents