Chapter 15 Development of a Nationwide Network for Ovarian Tissue Cryopreservation

Abstract

Ovarian tissue cryopreservation is gaining much interest since the publication of the first live birth after retransplantation of frozen-thawed tissue in 2004 (Donnez et al., Lancet 364:1405-1410, 2004). In contrast to cryopreservation of gametes and embryos, ovarian tissue freezing is a complex requiring a proper approach in order to make this a viable option for fertility preservation of cancer patients. Due to the need in terms of laboratory space, equipment, personnel, and adequate logistics, an ovarian tissue cryobank is most economic if managed as a centralized service unit that interacts with numerous clinics covering the surgical part. Transportation of ovarian tissue under appropriate conditions from the surgical unit to the cryobank for subsequent preparation and freezing has been shown to have no impact on cryo-survival (Schmidt et al., Hum Reprod 18:2654-2659, 2003; Isachenko et al., Fertil Steril 91:1556-1559, 2009). Several children have been born after retransplantation of such tissue that was derived from the cryobank in Bonn, Germany (Homepage FertiPROTEKT. http://www.fertiprotekt.de ). This cryobank is one of the largest in the world with more than 1300 tissue samples that were frozen from 2003 until today. It is integrated in the network FertiPROTEKT (Homepage FertiPROTEKT. http://www.fertiprotekt.de ) and is served by 108 surgical centers that are located all over Germany. The concept of this cryobank is a blueprint for success and has recently been used for another regionally centralized cryobank in Beijing, China. In this chapter the most important topics that need to be considered while creating a centralized cryobank within a national or regional network are highlighted.

Concept Paper on the Technique of Cryopreservation, Removal and Transplantation of Ovarian Tissue for Fertility Preservation

“…Those facilities which do not have possibilities for performing cryopreservation of ovarian tissue themselves can send the ovarian tissue for tissue processing to specialised centres with an affiliated cryobank 32 .…”

“…In general, two freezing techniques are used in reproductive medicine: the slow freezing method, a cryopreservation method with equilibration, and vitrification, a freezing method without equilibration 32 . Both methods are used worldwide in the cryopreservation of ovarian tissue.…”

“…Diejenigen Einrichtungen, die nicht die Möglichkeiten besitzen, eine Kryokonservierung von Ovarialgewebe selbst durchzuführen, können das ovarielle Gewebe für die Gewebeverarbeitung an spezialisierte Zentren mit angeschlossener Kryobank senden 32 .…”

“…Generell werden in der Reproduktionsmedizin 2 Einfriertechniken angewandt: das langsame Einfrierverfahren, ein Kryokonservierungsverfahren mit Äquilibrierung, und die Vitrifikation, ein Einfrierverfahren ohne Äquilibrierung 32 . Beide Methoden finden weltweit bei der Kryokonservierung von Ovarialgewebe Anwendung.…”

2019 Pediatric Initiative Network: Progress, Proceedings, and Plans

“…Based on this prior experience, as well as that of the Australasian Oncofertility registry, 36 FertiPROTEKT registry, 37 and Japanese FP registry, 38 in an effort to create a central repository for U.S. data regarding patients who have undergone OTC, the PIN Research Committee has decided to proceed with an effort to create a central repository for data regarding patients who have undergone OTC by: (1) revising all OTC data collection sheets into an updated centralized database to maximize information collected regarding the specifics of treatment, surgery, endocrine function, and obstetrical outcomes; (2) transitioning the database to a centralized site where there is institutional support for this endeavor with a research coordinator, database manager, designated legal team, and local grant funding for the longevity of the program; and (3) promoting vigorous academic output by encouraging each participating site to take ownership and submit research ideas, commit to participating in the chosen research idea, and have equal opportunity for authorship on every publication resulting from the database.…”