The removal of ovarian tissue for freezing (cryopreservation) for a later transplantation of the ovarian tissue in the case of a desire for children and a premature loss of ovarian function is an established and standardized reproductive medical technique. The method is recommended for young women of fertile age who have a direct or indirect risk of loss of ovarian function due to an oncological, haematological or other underlying disease. In addition, young girls for whom stimulation and egg freezing are not possible treatment options ovarian tissue cryopreservation should be considered.
A temporary restoration of the body’s own female hormone production with spontaneous pregnancies is one of the aims of this method. A major advantage of this technique is the short time required for the retrieval of ovarian tissue, as no hormonal preparation (stimulation) of the patient is necessary and the tissue can be retrieved at any time during the menstrual cycle. For the removal itself, the rule is: as much as necessary, as little as possible. Mostly, half an ovary is removed by laparoscopy, processed and frozen. It has been proven that pregnancies can be achieved even with a small amount of tissue without relevantly reducing the woman’s chance for a later spontaneous pregnancy (without transplantation).
Ovarian tissue obtained from outpatients in an ambulant setting should be transported immediately after collection to the processing site, where high-quality, standardized processing, cryopreservation and storage of ovarian tissue can be performed. If this is not possible, the FertiPROTEKT network offers the possibility of cooperating with specialized, external and centralised cryobanks. The transport takes place in special shipping containers provided directly after the surgical removal of the tissue. Several national and international publications show that this established and standardized transport in the FertiPROTEKT network functions without restrictions and apparently does not lead to any loss of tissue vitality and success rates after transplantation. The chance of a subsequent pregnancy and birth of a healthy child after transplantation of ovarian tissue by laparoscopy is higher the better the ovarian tissue function at the time of removal and before the start of oncological therapy can be preserved.
Detailed information and a bibliography can be found in the FertiPROTEKT booklet “Indikation und Durchführung fertilitätsprotektiver Maßnahmen bei onkologischen und nicht-onkologischen Erkrankungen”, 2nd revised edition 2020, which was written by members of the FertiPROTEKT Netzwerk e.V. and is available free of charge (in German).
(Chap. 3.3 – 3.5)
An english version can be bought: Fertility Preservation in Oncological and Non-Oncological Diseases a practical guide by Michael von Wolff & Frank Nawroth ISBN 978-3-030-47567-3 from Springer.com
Part III.III-III.V page 187ff
