Ovarian tissue

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.

(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