Endocrine Function and Oocyte Retrieval After Autologous Transplantation of Ovarian Cortical Strips to the Forearm

TLDR

Chemotherapy and pelvic radiotherapy cause premature ovarian failure, and although ovarian transposition has limited success due to scatter radiation and vascular compromise, autotransplantation of fresh or frozen ovarian cortical strips has emerged as a promising alternative that can restore ovarian function. The authors report the first case of laparoscopic transplantation of frozen ovarian tissue to the pelvic sidewall resulting in ovulation.

Abstract

distressing adverse effects of chemotherapy and pelvic radiotherapy is premature ovarian failure. 1 Previously, ovarian transposition was performed with varying degrees of success but the scatter radiation and vascular compromise limited its effectiveness. 2,3Moreover, this treatment could not protect against the gonadotoxicity of chemotherapy.Recently, a multitude of laboratory, animal, and human xenograft studies has described an emerging alternative for these patients: autotransplantation of fresh or frozenbanked ovarian cortical strips. 4In addition, many women experience premature menopause due to oophorectomies performed for benign ovarian cysts or endometriosis.Ovarian autotransplantation may restore ovarian function in these patients. 5,6e have reported the first case of laparoscopic transplantation of frozenthawed ovarian tissue to the pelvic sidewall with subsequent ovulation. 5,6owever, when there is a possibility that a patient may receive pelvic radiotherapy, or when close surveillance of ovarian tissue is required, a heterotopic location may be more desirable.