Two successful pregnancies following autotransplantation of frozen/thawed ovarian tissue

TLDR

Cryopreservation of ovarian cortex followed by autotransplantation has been experimentally used to preserve fertility in women undergoing treatment for malignant disease. This study reports ovarian activity and successful pregnancies after autotransplantation of frozen/thawed ovarian tissue. Six women aged 26–35 had one ovary cryopreserved, with tissue transported 4–5 h on ice before freezing, and after 17–32 months orthotopic autotransplantation replacing 20–60 % of the tissue, while two patients received additional heterotopic transplants. The transplanted tissue restored menstrual cycles within 14–20 weeks, and four of six women conceived—two delivered healthy children, one miscarried at week 7, one had a positive hCG without clinical pregnancy—while the remaining two did not become pregnant, and two more healthy children were born, demonstrating that hospitals can offer cryopreservation without local expertise.

Abstract

Cryopreservation of the ovarian cortex with subsequent autotransplantation has, on an experimental basis, been performed to preserve fertility in women being treated for a malignant disease. The present study reports ovarian activity and pregnancies following autotransplantation of frozen/thawed ovarian tissue. One complete ovary was cryopreserved from each of six patients who were 26–35 years old prior to treatment. Tissue from three of the patients was transported 4–5 h on ice prior to cryopreservation. After a period of 17–32 months, orthotopic autotransplantation was performed replacing 20–60% of the tissue. Two patients received additional heterotopic transplants. In all cases, the tissue restored menstrual cyclicity 14–20 weeks following transplantation. Four of the six women conceived following assisted reproduction: two women (who had the tissue transported 4–5 h prior to cryopreservation) each, based on the orthotopic transplanted tissue, delivered one healthy child (February 2007 and January 2008); one woman miscarriaged in gestational Week 7; and the other had a positive hCG test but no clinical pregnancy. The remaining two women did not become pregnant. Two additional healthy children have been born as a result of the ovarian cryopreservation procedure. In both cases, the ovarian tissue was transported 4–5 h prior to freezing demonstrating that hospitals may offer cryopreservation without having the necessary expertise locally.