The extremely high doses of C/T prior to bone marrow transplantation for treatment of hematological malignancies frequently result in long term sterility .—ovarian cryopreservation should be considered, when the underlying disease may remission and unlikely to contamination the harvest tissue.
prepubertal ovary remain extremely sensitive to radiation ->with doses of 5-20Gy ->ovarian failure.
from the University of Bologna studied 11 pregnancies from frozen eggs, which resulted in 13 children. In all but one of the pregnancies, amniocentesis was performed, showing that all of the fetuses were normal. They report that the gestational age at delivery was normal, and post-natal growth and development have all been reported normal.
2001, Dr. Kutluk Oktay transplanted a section of a woman's ovary into her forearm. Egg development and normal hormone production was achieved. Theoretically, the eggs could be removed and used for in vitro fertilization to achieve a pregnancy. Dr. Oktay had similar results with a second patient.
Consideration of Ovarian tissue autotransplantation
Safety : the residual disease in autografted ovarian tissues might cause recrudescence of disease.
kim et. al. : total 30 non-obese diabetic severe combined immunodeficient (SCID) mice were individually xenografted s.c. with frozen-thawed ovarian tissue from 18 patients with lymphoma,
Endocrine function and oocyte retrieval after autologous transplantation of ovarian cortical strips to the forearm(I) oktay, JAMA, september 26, 2001-286: 1490-3
Patient A , 35y/o woman, stage IIIb squamous cell Cx Ca. she consulted to fresh transplantation prior to pelvic radiotherapy.
Both ovaries were removed laparoscopically, and after frozen section showed no metastasis, their cortices were prepared in 16 strips were of 5x50x1-3mm.
Ovarian strips were wedged subcutaneously to the forearm prior to pelvic radiotherapy.
Patient B , 37 y/o woman with recurrent serous cyct in her only one ovary. Dense pelvic adhesion was noted.
Endocrine function and oocyte retrieval after autologous transplantation of ovarian cortical strips to the forearm(II)
Menopause was confirmed immediately after the transplantation in both Pt(A: 47mIU/ml, B:50.7mIU/ml)
Patient A : follicle development was noted by physical and ultrasound examination approximately 10 weeks after transplantation. The mean FSH, LH decreased to 8.6mIU/ml and 12.8 mIU/ml. The peripheral E2 showed cyclical variation, dominant follicle developed each months. Percutaneous oocyte aspiration yielded a mature oocyte after COH. Fertilization failure after ICSI
Patient B: spontaneous MC since 6 months after transplantation. mid-cycle LH surge and USG:a 9 mm follicle. Ovulation was confirmed via progesterone level after LH surge.