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Ovarian Tissue Cryopreservation — Oncofertility

Surgical removal and cryopreservation of ovarian cortical tissue from women and prepubertal girls before gonadotoxic treatment, allowing future autotransplantation to restore fertility, ovarian endocrine function, and quality of life.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Ovarian Tissue Cryopreservation — Oncofertility?

Ovarian tissue cryopreservation involves laparoscopic harvesting of cortical strips containing primordial follicles, slow-freezing or vitrification, and storage at –196°C in liquid nitrogen for years to decades.

Indications include cancer requiring chemotherapy or pelvic radiation (especially in prepubertal girls who cannot undergo IVF), severe autoimmune disease requiring cyclophosphamide, hematopoietic stem cell transplantation conditioning, and benign conditions risking premature ovarian insufficiency.

After cancer treatment and remission verification, autotransplantation of thawed tissue to ovary, pelvis, or heterotopic site (forearm, abdominal wall) restores ovarian function in about 95% of women, with conception rates of 30–40% and over 200 livebirths globally; the American Society for Reproductive Medicine removed experimental designation in 2019.

Symptoms

Suitable for cancer patients with imminent gonadotoxic treatment when no time for ovarian stimulation (1–2 weeks needed) — leukemia, lymphoma, breast cancer, sarcoma
Prepubertal girls — only fertility preservation option since IVF requires mature ovarian function
Severe autoimmune disease (SLE, vasculitis) needing cyclophosphamide — high gonadotoxic risk
Hematopoietic stem cell transplantation candidates — particularly with myeloablative conditioning
BRCA1/2 carriers planning prophylactic salpingo-oophorectomy at young age
Loss of menstrual cycles, hot flashes, low estradiol after gonadotoxic therapy indicate ovarian failure where transplantation may help

Risk Factors

Disease-specific concerns: leukemia and ovarian metastasis risk requires careful tissue screening before transplantation; minimal residual disease testing
Time pressure of urgent oncologic treatment may limit harvesting opportunity
Surgical risks of laparoscopic oophorectomy or partial oophorectomy (bleeding, infection, anesthesia)
Reduced ovarian reserve at baseline, advanced maternal age (over 35) lower expected outcomes
Chemotherapy or radiation already received before harvesting reduces tissue quality
Storage and laboratory quality control essential — accredited center with experience

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Newly diagnosed cancer with planned gonadotoxic therapy — urgent oncofertility consultation
  • Prepubertal girl with cancer or autoimmune disease needing cyclophosphamide — pediatric oncology and reproductive endocrinology coordination
  • BRCA1/2 carrier considering risk-reducing surgery — fertility specialist before procedure
  • Cancer survivor with premature ovarian insufficiency seeking autotransplantation — reproductive medicine evaluation
  • Postoperative bleeding, fever, or surgical complication — same-day evaluation

Treatment Methods

01
Pre-treatment counseling about indications, success rates (30–40% pregnancy after transplantation), risks, and alternatives (ovarian stimulation with embryo or oocyte cryopreservation if time and pubertal status allow)
02
Surgical harvesting via laparoscopy or laparotomy — typically partial oophorectomy or whole ovary; cortical strips dissected and prepared in dedicated lab
03
Cryopreservation by slow-freeze or vitrification with cryoprotectants; quality control and disease screening (especially leukemia)
04
Autotransplantation after cancer remission — orthotopic (ovarian remnant or peritoneum) or heterotopic (forearm, abdominal wall) sites; resumption of ovarian function expected within 4–9 months, lasts 4–7 years on average
05
Post-transplantation: monitor estradiol, FSH, antral follicle count; assist with conception via timed intercourse, IUI, or IVF as needed; consider repeat transplantation if function declines while patient still seeks fertility

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.