Experiences of young girls and women undergoing ovarian tissue cryopreservation: a systematic review and thematic synthesis

Khattak, Hajra; Woodman, Hannah; Afifi, Yousri; Amorim, Christiani Andrade; Fishel, Simon; Gallos, Ioannis; Coomarasamy, Arri; Topping, Annie

doi:10.1080/0167482x.2022.2084376

Cited by 3 publications

(5 citation statements)

References 41 publications

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“…Our data showed a transplantation rate of approximately 2% (30), ovarian function recovery rate about 93%, pregnancies rate of 40% and take-home baby rate of around 16%. Our data are in agreement with those reported by Khattak et al (16), that performed a meta-analysis of twenty studies reported on ≥5 cases of ovarian transplants (568 women). Fertility outcomes included pregnancy, live birth, miscarriage rates, and endocrine outcomes included estrogen, FSH and LH levels.…”

Section: Discussionsupporting

confidence: 94%

“…Our data are in agreement with those reported by Khattak et al. ( 16 ), that performed a meta-analysis of twenty studies reported on ≥5 cases of ovarian transplants (568 women). Fertility outcomes included pregnancy, live birth, miscarriage rates, and endocrine outcomes included estrogen, FSH and LH levels.…”

Section: Discussionsupporting

confidence: 94%

“…The pooled rates were 37% (95% CI: 32–43%) for pregnancy, 28% (95% CI: 24–34%) for live birth and 37% (95% CI: 30–46%) for miscarriage following frozen ovarian tissue transplantation. Also the hormones data show evidence of return of hormonal function after transplantation with significant decrease in FSH and LH, and an increase in estrogen post ovarian transplant, in accordance with the major achievements ( 16 ). AMH does not undergo substantial changes, turning out not to be an indicator that can help in understanding the state of ovarian activity post-OTT.…”

Section: Discussionsupporting

confidence: 73%

“…Recently some meta-analyzes have been conducted to analyze the data on fertility outcomes after OTT including pregnancy, live birth, miscarriage rates, and endocrine outcomes such as estrogen, Follicle Stimulating Hormone (FSH) and Luteinizing hormone (LH) levels. These analyses demonstrated that OTT could restore reproductive and hormonal functions in women submitted to the procedure (14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 96%

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Ovarian tissue transplantation: 10 years of experience at the Bologna University

Fabbri,

Vicenti,

Magnani

et al. 2024

Front. Endocrinol.

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ObjectiveThe efficiency of ovarian tissue transplantation (OTT) was established in terms of ovarian function recovery (95% of cases), number of live births (over 200 worldwide to date) and induction of puberty. Unfortunately, the lack of international registries and the fact that many centers have not yet reported their outcomes, lead to poor knowledge of the exact fertility data. The aim of the study is to describe our experience with OTT to restore ovarian function and fertility.MethodsThis study was designed as a single-center, observational, retrospective, cohort study that includes women who underwent OTT between December 2012 and June 2023 at our center. After approval by the oncologist/hematologist, a small fragment of ovarian tissue was thawed and analyzed to detect the presence of micrometastases before OTT. Thawed ovarian tissue was grafted laparoscopically at multiple sites, including the remaining ovary and pelvic side wall (orthotopic transplantation) and/or abdominal wall (heterotopic transplantation). After OTT, ovarian function was monitored by hormonal assay, ultrasound and color Doppler at approximately 4-week intervals.ResultsBetween December 2012 and June 2023, 30 women performed OTT. Prior to OTT, immunohistochemical and molecular analyses revealed no micrometastases in all thawed ovarian tissue samples. In our series of 30 women, 20 of women were on premature ovarian insufficiency (POI), and the remaining ten cases still had oligomenorrhea and difficulty getting pregnant. Among the women with POI before OTT and at least 6 months follow-up, recovery of endocrine function was observed in all but one woman who underwent orthotopic transplantation (13 of 14 cases), in one out of two women who underwent both orthotopic and heterotopic transplantation (1 of 2 cases) and in all women who underwent heterotopic transplantation (4 of 4 cases). Women who underwent OTT to enhance fertility had no alterations in menstrual cycle and hormonal levels. In total, ten pregnancies were obtained in 25 women, resulting in four live births, two ongoing pregnancies and four spontaneous abortions.ConclusionOur data can help patients and physicians in their discussions and decisions about the need and possibilities of preserving fertility.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 96%

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Ovarian tissue transplantation: 10 years of experience at the Bologna University

Fabbri,

Vicenti,

Magnani

et al. 2024

Front. Endocrinol.

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“…Young girls and their parents should make critical decisions about their health and fertility options, such as cryopreservation. Their emotional status, as well as the need for experienced personnel that will help them through the ordeal, should be considered [ 112 ]. Guidance about future fertility and preservation methods should not involve one physician.…”

Section: Discussionmentioning

confidence: 99%

Ovarian Tissue Cryopreservation in Children and Adolescents

et al. 2022

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Cancer during childhood and adolescence remains a major public health issue, affecting a significant portion of this age group. Although newer anti-cancer treatments have improved survival rates, this comes at a cost in terms of gonadotoxic effects. As a result, the preservation of fertility is important. Ovarian tissue cryopreservation, one of the newest methods, has some advantages, especially for prepubertal patients: no need for ovarian stimulation, thus, no further risk for estrogen-sensitive cancer types, and preservation of more and better-quality primordial follicles of the ovarian cortex. The most frequent indications include treatment with alkylating agents, ovarian-focused radiotherapy, leukemias, lymphomas, brain and neurological tumors, as well as Turner syndrome and benign hemoglobinopathies. An expected survival exceeding 5 years, the absence of systematic disease and an overall risk of premature ovarian insufficiency over 50% are among the criteria that need to be fulfilled in order for a patient to undertake this method. Orthotopic transplantation is more frequently used, since it can allow both live birth and the recovery of endocrine function. Reimplantation of malignant cells is always a major risk and should always be taken into consideration. Histological analysis, as well as immunohistochemical and molecular methods, are needed in order to improve the search for malignant cells before transplantation. Ovarian tissue cryopreservation appears to be a method with specific benefits, indications and risks which can be an important tool in terms of preserving fertility in younger women.

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Exploring the Frontiers of Ovarian Tissue Cryopreservation: A Review

Ramirez,

Pavone

2024

JCM

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Objective: This paper serves as an up-to-date narrative review of the most effective methods and outcomes of ovarian tissue cryopreservation (OTC) with new data comparing this method to oocyte and embryo cryopreservation as well as its utility in restoration of endocrine function. Background: Data on OTC are becoming more available as more patients are achieving cancer remission and choosing to use their cryopreserved tissue to conceive or restore endocrine function. With OTC only recently becoming a non-experimental method of fertility preservation, it is important to evaluate, compare, and optimize current practices to improve live birth outcomes. Methods: A literature search of meta-analyses, systematic reviews, case series, retrospective studies, and randomized control trials was performed using the PubMed database with multiple search terms. Discussion: Current practices and outcomes of OTC remain heterogeneous, though they are becoming more streamlined with the emerging data on successful live births. Multiple aspects of OTC have been studied to optimize protocols, particularly methods of cryopreserving, in vitro maturation, and transplantation. In vitro follicle maturation is a novel application with emerging data on methods and outcomes. OTC is a versatile method not only for fertility preservation but also for hormone restoration as well. With wider usage of OTC, ethical dilemmas will need to be addressed. Conclusions: OTC can be used as fertility preservation for a variety of patients. Recent studies suggest it may be comparable to embryo cryopreservation, but with growing data on live births, comparative studies should continue to be performed. In vitro follicle maturation (IVFM) is a promising application of ovarian tissue harvesting. Data are lacking on cost-effectiveness, patient satisfaction, and morbidity associated with OTC.

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Experiences of young girls and women undergoing ovarian tissue cryopreservation: a systematic review and thematic synthesis

Cited by 3 publications

References 41 publications

Ovarian tissue transplantation: 10 years of experience at the Bologna University

Ovarian tissue transplantation: 10 years of experience at the Bologna University

Ovarian Tissue Cryopreservation in Children and Adolescents

Exploring the Frontiers of Ovarian Tissue Cryopreservation: A Review

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