Ovarian tissue cryopreservation is a technique that involves the freezing and storage of tissue from the ovarian cortex. This tissue holds primordial follicles, each containing a single immature egg. Total or partial oophorectomy (the removal of the ovary) is, generally performed using a minimally invasive surgical procedure. After removal of the ovarian tissue, the cortex is dissected off the medulla, cut into thin strips, and frozen.
Who is Eligible?
Pre-menopausal females who do not have adequate time for egg or embryo freezing and pre-pubertal females who are not able to undergo ovarian stimulation and egg retrieval may want to consider this option. Women choosing ovarian tissue cryopreservation have a planned cancer treatment regimen that carries a high risk of infertility.
What are the Potential Risks/Concerns?
There is a risk of complications from anesthesia. To minimize this risk, ovarian tissue cryopreservation may be scheduled with another procedure requiring anesthesia. Invasive procedures also carry a risk of infection. To minimize this risk, a patient may be given prophylactic antibiotics. There is also a potential risk of reseeding cancer cells when ovarian tissues are re-implanted. Ovarian tissue cryopreservation is only available at selected reproductive endocrinology centers and some children’s hospitals.
Future Use and Success Rates
Ovarian tissue cryopreservation is no longer considered an experimental procedure by the American Society for Reproductive Medicine (ASRM). However, it remains a fairly uncommon procedure, and patients should enquire about the experience of the surgical center/clinic they are considering. About 130 babies have been born world-wide using re-implantated ovarian tissue; only one birth has been reported in a patient whose ovarian tissue was cryopreserved pre-pubertally. In addition, while methods of maturing the immature eggs in the stored tissue in the lab are being studied, there have been no births to date using this approach (known as in vitro maturation).
Additional Resources
- ASRM Practice Committee Guidance recognizes OTC as no longer experimental
- OTC Considerations for prepubertal patients