Treatment history and outcome of 24 deliveries worldwide after autotransplantation of cryopreserved ovarian tissue, including two new Danish deliveries years after autotransplantation

Abstract

Purpose To report another two successful pregnancies and deliveries resulting from autotransplanted cryopreserved ovarian tissue several years after the autotransplantation procedure took place. Further, to review the literature on the treatment history, number of live births and their outcome so far reported worldwide. Methods Two women underwent fertility preservation with cryopreservation of their ovarian tissue prior to a potentially sterilizing treatment with bone marrow transplantation. One woman suffered from paroxystic nocturnal hemoglobinuria and one woman from relapse of Hodgkin′s lymphoma. Both suffered from premature ovarian insufficiency after treatment. Because of a pregnancy wish they later had pieces of thawed cortical tissue transplanted to the remaining ovary and the anterior abdominal wall. PubMed was searched for reports of deliveries resulting from cryopreserved ovarian tissue in peer-reviewed papers. Results Five years after the autotransplantation the first patient became spontaneously pregnant and delivered a healthy baby boy at term. The second patient became pregnant after undergoing one cycle of in vitro fertilisation five years after the autotransplantation. She delivered a healthy baby boy at gestational week 36. Twenty healthy singletons and two sets of twins have been born according to peer-reviewed publications. Conclusion Contrary to most of the published deliveries our latest two cases occurred several years after the autotransplantation procedure took place. This proves that ovarian grafts are capable of functioning for several years after the autotransplantation has occurred. Today, a total of 26 healthy children have been born as a result of cryopreservation of ovarian tissue.

86 successful births and 9 ongoing pregnancies worldwide in women transplanted with frozen-thawed ovarian tissue: focus on birth and perinatal outcome in 40 of these children

“…All the women who obtained a NC pregnancy had grafts transplanted to the remaining ovary. One woman also had pieces transplanted to a peritoneal pocket in the anterior abdominal wall [23] and two women also had pieces transplanted to one of the broad ligaments (case 3 and 4 in this study). Out of the five women who received IVF treatment, two women had grafts transplanted only to the remaining ovary (three children were conceived, child no.…”

“…Most of the pregnancies have been conceived within the first 3 years after autotransplantation, but Macklon and coworkers reported two new cases where the conception occurred 5 and 6 years after autotransplantation [23], also sustaining long-term fertility.…”

Successful cryopreservation of whole sheep ovary by using DMSO-free cryoprotectant

“…However, cancer therapies such as radial and chemical therapy cause severe injuries to the ovarian reserve, which may subsequently lead to ovarian failure and infertility [2]. Maintaining their fertility is of the utmost importance to many patients diagnosed with cancer during their child-bearing years, and research on the cryopreservation of ovarian tissue has been proved to have great potential for clinical applications in transplantation therapy, making it a promising area for female infertility treatment [3]. There are two options available to achieve such cryopreservation: the preservation of an ovarian cortical fragment or the preservation of the whole ovary.…”

“…There are two options available to achieve such cryopreservation: the preservation of an ovarian cortical fragment or the preservation of the whole ovary. The first technique is most commonly used in clinical applications due to its effective cryopreservation [3,4]; however, this method has the damaging side effect of follicle loss, caused by ischemia, most of which occurs during the transplantation process [5,6]. Therefore, whole ovary cryopreservation along with vascular reanastomosis, which can minimize ischemia damage to the tissue and prolong graft longevity, has been proposed as a promising alternative to the cryopreservation of only an ovarian cortical fragment.…”

Pharmacological options for the protection of ovarian function in patients undergoing chemotherapy

“…4 This technique is still regarded by many experts as experimental, but successful pregnancies have been reported from thawed, previously cryopreserved, ovarian tissue. 5 This review will focus on hormonal manipulation during chemotherapy.…”