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Current Success and Efficiency of Autologous Ovarian Transplantation: A Meta-Analysis

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Abstract

Context

Ovarian cryopreservation followed by autotransplantation is still considered an experimental strategy for fertility preservation (FP) mainly because the success rates are unknown.

Objective

To determine cohort epidemiologic characteristics and success rates of autologous ovarian tissue transplantation (OTT) with previously cryopreserved tissue.

Materials and Methods

Literature review from 1999 to October 1, 2016. Additional cases were retrieved from meeting abstracts and own database. We selected studies that reported autologous OTT with previously banked tissue in humans. We did not include any cases involving fresh ovarian tissue transplantation or those performed to treat idiopathic premature ovarian failure/insufficiency. Both authors reviewed and selected studies for eligibility, which resulted in 59 full-text studies assessed for eligibility. Cases were extracted from original reports and reviews by the junior author, and the senior author reviewed and verified the extracted data.

Results

Nineteen reports were included for qualitative synthesis. In 10 studies, detailed data were available to determine clinical and live birth + ongoing (LB + OG) pregnancy as well as endocrine restoration rates. Three hundred nine OTTs were performed with cryopreserved tissue, resulting in the birth of 84 children and 8 OG pregnancies. The cumulative clinical and LB + OG rates were 57.5% and 37.7%, respectively, and the endocrine restoration rate was 63.9%.

Conclusion

Success rates with cryopre-served OTT have reached promising levels. Given these recent data, ovarian tissue cryopreservation should be considered as a viable option for FP.

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References

  1. Parkes AS, Smith AU. Regeneration of rat ovarian tissue grafted after exposure to low temperatures. Proc R Soc Lond B Biol Sci. 1953;140(901):455–470.

    CAS  PubMed  Google Scholar 

  2. Deanesly R. Immature rat ovaries grafted after freezing and thawing. J Endocrinol. 1954;11(2):197–200.

    CAS  PubMed  Google Scholar 

  3. Newton H, Aubard Y, Rutherford A, Sharma V, Gosden R. Low temperature storage and grafting of human ovarian tissue. Hum Reprod. 1996;11(7):1487–1491.

    CAS  PubMed  Google Scholar 

  4. Oktay K, Newton H, Mullan J, Gosden RG. Development of human primordial follicles to antral stages in SCID/hpg mice stimulated with follicle stimulating hormone. Hum Reprod. 1998;13(5):1133–1138.

    CAS  PubMed  Google Scholar 

  5. Gosden RG, Baird DT, Wade JC, Webb R. Restoration of fertility to oophorectomized sheep by ovarian autografts stored at e196 degrees C. Hum Reprod. 1994;9:597–603.

    CAS  PubMed  Google Scholar 

  6. Oktay K, Karlikaya G. Ovarian function after transplantation of frozen, banked autologous ovarian tissue. N Engl J Med. 2000;342(25):1919.

    CAS  PubMed  Google Scholar 

  7. Oktay K, Oktem O. Fertility preservation medicine: a new field in the care of young cancer survivors. Pediatr Blood Cancer. 2009;53(2):267–273.

    PubMed  Google Scholar 

  8. Oktay K, Buyuk E, Veeck L, et al. Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet. 2004;363(9412):837–840.

    PubMed  Google Scholar 

  9. Oktay K. Spontaneous conceptions and live birth after heterotopic ovarian transplantation: is there a germline stem cell connection? Hum Reprod. 2006;21(6):1345–1348.

    PubMed  Google Scholar 

  10. Oktay K, Oktem O. Ovarian cryopreservation and transplantation for fertility preservation for medical indications: report of an ongoing experience. Fertil Steril. 2010;93(3):762–768.

    PubMed  Google Scholar 

  11. Oktay K, Bedoschi G, Pacheco FS, Turan V, Emirdar V. First pregnancies, live-birth, and in vitro fertilization outcomes after transplantation of frozen-banked ovarian tissue with a human extracellular matrix scaffold using robot-assisted minimally invasive surgery. Am J Obstet Gynecol. 2016;214(1):94.e1–e9.

    Google Scholar 

  12. Azem F, Amit A, Vagman I, Mey Raz N, Ben-Yosef D, Lessing J. Successful pregnancy and birth following avascular micro ovarian tissue orthotopic transplantation in a patient with Hodgkin disease. Scientific Congress Supplement: oral and poster abstracts. Fertil Steril. 2012;98(3):S95–S96.

    Google Scholar 

  13. Donnez J, Dolmans MM, Pellicer A, et al. Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue: a review of 60 cases of reimplantation. Fertil Steril. 2013;99(6):1503–1513.

    PubMed  Google Scholar 

  14. Donnez J, Dolmans MM. Ovarian cortex transplantation: 60 reported live births brings the success and worldwide expansion of the technique towards routine clinical practice. J Assist Reprod Genet. 2015;32(8):1167–1170.

    PubMed  PubMed Central  Google Scholar 

  15. Dunlop CE, Brady BM, McLaughlin M, et al. Re-implantation of cryopreserved ovarian cortex resulting in restoration of ovarian function, natural conception and successful pregnancy after haematopoietic stem cell transplantation for Wilms tumour. J Assist Reprod Genet. 2016;33(12):1615–1620.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Fabbri R, Pasquinelli G, Magnani V, et al. Autotransplantation of cryopreserved ovarian tissue in oncological patients: recovery of ovarian function. Future Oncol. 2014;10(4):549–561.

    CAS  PubMed  Google Scholar 

  17. Imbert R, Moffa F, Tsepelidis S, et al. Safety and usefulness of cryopreservation of ovarian tissue to preserve fertility: a 12-year retrospective analysis. Hum Reprod. 2014;29(9):1931–1940.

    CAS  PubMed  Google Scholar 

  18. Demeestere I, Simon P, Dedeken L, et al. Live birth after auto-graft of ovarian tissue cryopreserved during childhood. Hum Reprod. 2015;30(9):2107–2109.

    PubMed  Google Scholar 

  19. Jensen AK, Kristensen SG, Macklon KT, et al. Outcomes of transplantations of cryopreserved ovarian tissue to 41 women in Denmark. Hum Reprod. 2015;30(12):2838–2845.

    CAS  PubMed  Google Scholar 

  20. Kim SS, Lee WS, Chung MK, Lee HC, Lee HH, Hill D. Long-term ovarian function and fertility after heterotopic autotransplantation of cryobanked human ovarian tissue: 8-year experience in cancer patients. Fertil Steril. 2009;91(6):2349–2354.

    PubMed  Google Scholar 

  21. Kiseleva M, Malinova I, Komarova E, Shvedova T, Chudakov K. The Russian experience of autotransplantation of vitrified ovarian tissue to a cancer patient. Gynecol Endocrinol. 2014;30(suppl 1): 30–31. doi:10.1007/s10815-016-0805-2.

    PubMed  Google Scholar 

  22. Lorenzo F, Villamayor M, Viola J, Tiveron M, Young E. Second children born after autotransplantation of cryopreserved ovarian tissue in a young patient previously treated with chemotherapy for Askin’s disease. The successful of fertility preservation program. Fertil Steril. 2016;106(suppl 3):e29.

    Google Scholar 

  23. Meirow D, Ra’anani H, Shapira M, et al. Transplantations of frozen-thawed ovarian tissue demonstrate high reproductive performance and the need to revise restrictive criteria. Fertil Steril. 2016;106(2):467–474.

    PubMed  Google Scholar 

  24. Póvoa A, Xavier P, Calejo L, et al. First transplantation of cryopreserved ovarian tissue in Portugal, stored for 10 years: an unexpected indication. Reprod Biomed Online. 2016;32(3):334–336.

    PubMed  Google Scholar 

  25. Silber S, Pineda J, Lenahan K, DeRosa M, Melnick J. Fresh and cryopreserved ovary transplantation and resting follicle recruitment. Reprod Biomed Online. 2015;30(6):643–650.

    PubMed  Google Scholar 

  26. Stern K, Rozen G, Gook D, Agresta F, Braat D, Hale L. Are there factors which predict the success of ovarian tissue grafting in oncofertility patients? Abstract presented at: 32nd Annual Meeting of the European Society of Human Reproduction and Embryology; 3–6 July 2016; Helsinki, Finland.

    Google Scholar 

  27. Tanbo T, Greggains G, Storeng R, Busund B, Langebrekke A, Fedorcsak P. Autotransplantation of cryopreserved ovarian tissue after treatment for malignant disease—the first Norwegian results. Acta Obstetr Gynecol Scand. 2015;94(9):937–941.

    Google Scholar 

  28. Van der Ven H, Liebenthron J, Beckmann M, et al. FertiPROTEKT Network. Ninety-five orthotopic transplantations in 74 women of ovarian tissue after cytotoxic treatment in a fertility preservation network: tissue activity, pregnancy and delivery rates. Hum Reprod. 2016;31(9):2031–2041.

    PubMed  Google Scholar 

  29. Donnez J, Dolmans MM, Diaz C, Pellicer A. Ovarian cortex transplantation: time to move on from experimental studies to open clinical application. Fertil Steril. 2015;104(5):1097–1098.

    PubMed  Google Scholar 

  30. Callejo J, Salvador C, Gonzalez-Nunez S, et al. Live birth in a woman without ovaries after autograft of frozen-thawed ovarian tissue combined with growth factors. J Ovarian Res. 2013;6(1):33.

    PubMed  PubMed Central  Google Scholar 

  31. Demeestere I, Simon P, Emiliani S, Delbaere A, Englert Y. Fertility preservation: successful transplantation of cryopreserved ovarian tissue in a young patient previously treated for Hodgkin’s disease. Oncologist. 2007;12(12):1437–1442.

    PubMed  Google Scholar 

  32. Dittrich R, Hackl J, Lotz L, Hoffmann I, Beckmann MW. Pregnancies and live births after 20 transplantations of cryopreserved ovarian tissue in a single center. Fertil Steril. 2015;103(2):462–468.

    PubMed  Google Scholar 

  33. Rodriguez-Wallberg KA, Karlstrom PO, Rezapour M, et al. Full-term newborn after repeated ovarian tissue transplants in a patient treated for Ewing sarcoma by sterilizing pelvic irradiation and chemotherapy. Acta Obstetr Gynecol Scand. 2015;94(3):324–328.

    Google Scholar 

  34. Oktay K, Aydin BA, Karlikaya G. A technique for laparoscopic transplantation of frozen-banked ovarian tissue. Fertil Steril. 2001;75(6):1212–1216.

    CAS  PubMed  Google Scholar 

  35. Meirow D, Levron J, Eldar-Geva T, et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med. 2005;353(3):18–21.

    Google Scholar 

  36. Silber SJ, DeRosa M, Pineda J, et al. A series of monozygotic twins discordant for ovarian failure: ovary transplantation (cortical versus microvascular) and cryopreservation. Human Reprod. 2008;23(7):1531–1537.

    CAS  Google Scholar 

  37. Donnez J, Dolmans MM, Demylle D, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet. 2004;364(9443):1405–1410.

    CAS  PubMed  Google Scholar 

  38. Donnez J, Silber S, Andersen CY, et al. Children born after auto-transplantation of cryopreserved ovarian tissue. a review of 13 live births. Ann Med. 2011;43(6):437–450.

    PubMed  Google Scholar 

  39. Roux C, Amiot C, Agnani G, Aubard Y, Rohrlich PS, Piver P. Live birth after ovarian tissue autograft in a patient with sickle cell disease treated by allogeneic bone marrow transplantation. Fertil Steril. 2010;93(7):2413.e15–e19.

    Google Scholar 

  40. Revelli A, Marchino G, Dolfin E, et al. Live birth after orthotopic grafting of autologous cryopreserved ovarian tissue and spontaneous conception in Italy. Fertil Steril. 2013;99(1):227–230.

    PubMed  Google Scholar 

  41. Oktay K, Economos K, Kan M, Rucinski J, Veeck L, Rosenwaks Z. Endocrine function and oocyte retrieval after autologous transplantation of ovarian cortical strips to the forearm. JAMA. 2001;286(12):1490–1493.

    CAS  PubMed  Google Scholar 

  42. Stern CJ, Gook D, Hale LG, et al. First reported clinical pregnancy following heterotopic grafting of cryopreserved ovarian tissue in a woman after a bilateral oophorectomy. Hum Reprod. 2013;28(11):2996–2999.

    CAS  PubMed  Google Scholar 

  43. Webber L, Davies M, Anderson R, et al. European Society for Human Reproduction and Embryology (ESHRE) Guideline Group on POI. ESHRE Guideline: management of women with premature ovarian insufficiency. Human Reprod. 2016;31(5):926–937.

    CAS  Google Scholar 

  44. Oktay K, Buyuk E. Ovarian transplantation in humans: indications, techniques and the risk of reseeding cancer. Eur J Obstet Gynecol Reprod Biol. 2004;113(suppl 1):S45–S47. doi:10.1371/journal.pone.0019475.

    PubMed  Google Scholar 

  45. Sonmezer M, Oktay K. Fertility preservation in female patients. Human Reprod Update. 2004;10(3):251–266.

    Google Scholar 

  46. Curtin JP, Barakat RR, Hoskins WJ. Ovarian disease in women with breast cancer. Obstet Gynecol. 1994;84(3):449–452.

    CAS  PubMed  Google Scholar 

  47. Oktay K, Turan V, Bedoschi G, Pacheco FS, Moy F. Fertility preservation success subsequent to concurrent aromatase inhibitor treatment and ovarian stimulation in women with breast cancer. J Clin Oncol. 2015;33(22):2424–2429.

    PubMed  PubMed Central  Google Scholar 

  48. Stern CJ, Gook D, Hale LG, et al. Delivery of twins following heterotopic grafting of frozen-thawed ovarian tissue. Human Reprod. 2014;29(8):1828.

    CAS  Google Scholar 

  49. Baird DT, Webb R, Campbell BK, Harkness LM, Gosden RG. Long-term ovarian function in sheep after ovariectomy and transplantation of autografts stored at −196 C. Endocrinology. 1999;140(1):462–471.

    CAS  PubMed  Google Scholar 

  50. Bromer JG, Patrizio P. Fertility preservation: the rationale for cryopreservation of the whole ovary. Semin Reprod Med. 2009;27(6):465–471.

    PubMed  Google Scholar 

  51. Bedaiwy MA, Hussein MR, Biscotti C, Falcone T. Cryopreservation of intact human ovary with its vascular pedicle. Human Reprod. 2006;21(12):3258–3269.

    Google Scholar 

  52. Soleimani R, Heytens E, Oktay K. Enhancement of neoangiogenesis and follicle survival by sphingosine-1-phosphate in human ovarian tissue xenotransplants. PloS One. 2011;6(4):e19475.

    CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Innovation Institute for Fertility Preservation and IVF, 4 Columbus Circle, New York, NY, 10019, USA

    Fernanda Pacheco MD, MBA & Kutluk Oktay MD, PhD

  2. Division of Reproductive Medicine, Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY, USA

    Fernanda Pacheco MD, MBA & Kutluk Oktay MD, PhD

  3. Classiclínica, Porto Alegre, Rio Grande do Sul, Brazil

    Fernanda Pacheco MD, MBA & Kutluk Oktay MD, PhD

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  1. Fernanda Pacheco MD, MBA
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  2. Kutluk Oktay MD, PhD
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Correspondence to Kutluk Oktay MD, PhD.

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Pacheco, F., Oktay, K. Current Success and Efficiency of Autologous Ovarian Transplantation: A Meta-Analysis. Reprod. Sci. 24, 1111–1120 (2017). https://doi.org/10.1177/1933719117702251

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