Claus Yding Andersen
Increased survival rates especially among young cancer patients have resulted in more and more fertility centers worldwide have acknowledged that fertility preservation is becoming an important quality of life issue to the growing population of cancer survivors treated during their fertile years. If the ovaries become depleted of follicles the woman will become sterile, loose menstrual cycles and many women experience profound effects on the physical and psychological status. For young girls it may further imply that pubertal development fails. Cryopreservation of ovarian tissue involves removal of one ovary prior to treatment. When the women have been cured and is considered fit, the thawed ovarian tissue with a viable pool of follicles can be transplanted to women who entered menopause. The surviving pool of primordial follicles will start to grow and the patients will regain fertility and will experience cyclic variation in sex hormone levels.
In Denmark where our laboratory is the only center that performs ovarian freezing almost 425 girls and women have had ovarian tissue cryopreserved. The youngest girl was 0.5 years old and the oldest 38 years.
In Denmark a total of fifteen women (10 having their tissue transported prior to cryopreservation) have experienced transplantation of frozen/thawed ovarian tissue a total of 21 times (6 women having tissue transplanted twice). All women regained ovarian function and none have experienced relapse as a consequence of the transplantation. Over a period of 2025 weeks levels of FSH gradually return to pre-menopausal levels and menstrual cycles are regained. Most women experience return of ovarian function for some years with just a fraction of tissue from one ovary being replaced.
Five of the women have been pregnant; in most cases as a result of assisted reproduction. Two women have delivered three healthy babies as a result of transplanted frozen/thawed ovarian tissue. The presentation will review our experience with this method.