Ovarian tissue cryopreservation in cancer patients – six years of clinical experience

Authors: M. Huser 1;  J. Žáková 1;  I. Crha 1;  L. Šmardová 2;  Z. Král 2;  A. Revel 3;  P. Ventruba 1
Authors‘ workplace: Gynekologicko-porodnická klinika LF MU a Fakultní nemocnice Brno, přednosta prof. MUDr. P. Ventruba, DrSc., MBA 1;  Interní hemato-onkologická klinika LF MU a Fakultní nemocnice Brno, přednosta prof. MUDr. J. Mayer, CSc. 2;  Department of Obstetrics and Gynecology, Hadassah University Hospital Ein-Karem, Jerusalem, Izrael, Head prof. N. Laufer 3
Published in: Čes. Gynek.2012, 77, č. 2 s. 118-126
Category: Original Article


Presentation of clinical results and experience with this technique during past six years.

Original paper.

Gynekologicko-porodnická klinika LF MU a FN Brno, Interní hemato-onkologická klinika LF MU a FN Brno, Department of Obstetrics and Gynecology. Hadassah University Hospital Ein-Karem, Jerusalem, Izrael.

Ovarian tissue cryopreservation (OTC) and its future auto-transplantation becomes an alternative for patients to prevent serious damage of ovarian function by oncology treatment.

Patient is indicated to OTC in case of high risk of ovarian failure due to planned chemotherapy and impossibility to use other oncofertility techniques. Ovarian tissue harvesting is done by laparoscopy in short-term general anesthesia. After tissue processing the samples are cryopreserved in programmable automatic freezer or by vitrification. The auto-transplantation of ovarian tissue is planned after the complete cure of patient’s malignancy. Our workplace doesn’t have own experience with tissue transplantation – until now cryopreserved tissue has not yet been utilized by the patients. Clinical experience with this technique gained by our team during academic stay in abroad Israeli clinic is presented.

During the years of 2005–2011 the OTC was performed in 19 cancer patients before chemotherapy. In majority of cases, patients suffered from blood or lymph node systemic malignancy (84%). Average age of women was 26 years. The patient set consisted of mostly nulliparous women (88%). Patient’s average body mass index was 23,9 kg/m2. The length of systemic chemotherapy averaged 7.1 months. Time from fertility preservation counseling to chemotherapy was not exceeding one week (7.2 days on average). Ovarian tissue harvesting was conducted by laparoscopic surgery in all cases. The length of surgery did not exceed 60 minutes and no surgical complications were observed. The case of ovarian tissue transplantation performed on abroad university settings is discussed.

In the consensus of with international guidelines OTC is offered to patients with high risk of ovarian failure doe to cytotoxic oncology treatment. Research in the field of oncofertility is focused on the techniques of in-vitro folliculogenesis in retrieved ovarian tissue.

Key words:
cancer, infertility, fertility preservation, ovarian tissue cryopreservation, oncofertility.


1. Amorim, CA., Van Langendonckt, A., David, A., et al. Survival of human pre-antral follicles after cryopreservation of ovarian tissue, follicular isolation and in vitro culture in a calcium alginate matrix. Hum Reprod, 2009, 24, p. 92-99.

2. Anderson, RA., Weddell, A., Spoudeas, HA., et al. Do doctors discuss fertility issues before they treat young patients with cancer? Hum Reprod, 2008, 23, p. 2246-2251.

3. Baier, DT., Webb, R., Campbell, BK., et al. Long-term ovarian function in sheep after ovariectomy and transplantation of autografts stored at -196 C. Endokrinology, 1999, 140, p. 462‑471.

4. Bedaiwy, MA., El-Nashar, SA., El Saman, AM., et al. Reproductive outcome after transplantation of ovarian tissue: a systematic review. Hum Reprod, 2008, 23, p. 2709-2717.

5. Danforth, H. Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in cancer patients. Fertil Steril, 2005, 83, p. 1622-1628.

6. Demeestere, I., Simon, P., Buxant, F., et al. Ovarian function and spontaneous pregnancy after combined heterotopic and orthotopic cryopreserved ovarian tissue transplantation in a patient previously treated with bone marrow transplantation: case report. Hum Reprod, 2006, 21, p. 2010-2014.

7. Demeestere, I., Simon, P., Emiliani, S., et al. Fertility preservation: successful transplantation of cryopreserved ovarian tissue in a young patient previously treated for Hodgkin’s disease. Oncologist, 2007, 12, p. 1437-1442.

8. Donnez, J., Dolmans, MM., Demylle, D., et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet, 2004, 364, p. 1405-1410.

9. Donnez, J., Squifflet, J., Van Rycl, AS., et al. Restoration of ovarian function in orthotopically transplanted cryopreserved ovarian tissue: a pilot experience. Reprod Biomed Online, 2008, 16, p. 694-704.

10. Gook, DA., Edgar, DH., Borg, J., et al. Diagnostic assessment of the developmental potential of human cryopreserved ovarian tissue from multiple patients using xenografting. Hum Reprod, 2005, 20, p. 72-78.

11. Hernandez-Fonseca, H., Bosch, P., Sirisathien, S., et al. Effect of site of transplantation on follicular development of human ovarian tissue transplanted into intact or castrated immunodeficient mice. Fertil Steril, 2004, 81, p. 888-892.

12. Hovatta, O. Methods for cryopreservation of human ovarian tissue. Reprod Biomed Online, 2005, 10, p. 729-734.

13. Huser, M., Crha, I., Žákova, J., Ventruba, P. Proces reprodukčního stárnutí ženy – příčiny, stanovení a možnosti užití v praxi. Čes Gynek, 2010, 75, p. 353-358.

14. Huser, M., Crha, I., Žákova, J., Ventruba, P. Onkofertilita – nový směr reprodukční medicíny. Čes Gynek, 2011, 76, s. 91-99.

15. Imhof, M., Bergmeister, H., Lipovec, M., et al. Orthotopic microvascular reanastomosis of whole cryopreserved ovine ovaries resulting in pregnancy and live birth. Fertil Steril, 2006, 85, p. 1208-1215.

16. Isachenko, V., Isachenko, E., Reinsberg, J., et al. Cryopreservation of human ovarian tissue: effect of spontaneous and initiated ice formation. Reprod Biomed Online, 2008, 16, p. 336-345.

17. Kim, SS., Yang, HW., Kang, HG., et al. Quantitative assessment of ischemic tissue damage in ovarian cortical tissue with or without antioxidant (ascorbic acid) treatment. Fertil Steril, 2004, 82, p. 679-685.

18. Lee, SJ., Schovej, LR., Partridge, AH., et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol, 2006, 24, p. 2917-2931.

19. Meirow, D., Levron, J., Eldar-Geva, T., et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med, 2005, 353, p. 318-321.

20. Newton, H., Aubard, Y., Rutherford, A., et al. Low temperature storage and grafting of human ovarian tissue. Hum Reprod, 1996, 11, p. 1487-1491.

21. Nisolle, M., Casanas-Roux, F., Qu, J., et al. Histologic and ultrastructural evaluation of fresh and frozen-thawed human ovarian xenografts in nude mice. Fertil Steril, 2000, 74, p. 122‑129.

22. Oktay, K. Ovarian tissue cryopreservation and transplantation: preliminary findings and implications for cancer patients. Hum Reprod Update, 2001, 7, p. 526-534.

23. Revel, A., Revel-Vilk, S., Aizenman, E., et al. At what age can human oocytes be obtained? Fertil Steril, 2009, 92, p. 458-463.

24. Silber, SJ., DeRosa, M., Pineda, J., et al. A series of monozygotic twins discordant for ovarian failure: ovary transplantation (cortical versus microvascular) and cryopreservation. Hum Reprod, 2008, 23, p. 1531-1537.

25. Wallace, WH., Anderson, RA., Irvine, DS. Fertility preservation for young patients with cancer: who is at risk and what can be offered? Lancet Oncol, 2005, 6, p. 209-218.

26. Xu, M., Barrett, SL., West-Farrell, E.,et al. In vitro grown human ovarian follicles from cancer patients support oocyte growth. Hum Reprod, 2009, 24, p. 2531-2540.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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