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Long-Term Ovarian Function Evaluation after Autografting by Implantation with Fresh and Frozen-Thawed Human Ovarian Tissue

Department of Obstetrics and Gynecology, Hospital Universitari Sant Joan de Déu (J.C., C.S., S.V., J.M.L.), Cancer Research Institute (A.M.), and Institut Clínic of Gynecology, Obstetrics and Neonatology (J.B.), Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine–University of Barcelona, 08950 Esplugues, Barcelona, Spain

Address all correspondence and requests for reprints to: Justo Callejo, M.D., Department of Obstetrics and Gynecology, Hospital Universitari Sant Joan de Déu, Po Sant Joan de Déu no 2, 08950 Esplugues, Barcelona, Spain. E-mail: jcallejo{at}medicina.ub.es

Abstract

The transplantation of ovarian tissue has recently been the focus of intense investigation with the aim of avoiding premature ovarian failure mainly in patients receiving chemotherapy or radiotherapy for malignant disease. Here, we present an evaluation of the long-term function of both fresh (patients 1, 2, and 3) and cryopreserved (patient 4) ovarian autografts in four premenopausal patients aged 46–49 yr who underwent heterotopic ovarian transplantation and were followed over a 1-yr period without receiving gonadotropins to stimulate follicular growth. In patients 1 and 2, 1 cm³ ovarian cortical autograft was placed sc in the inner aspect of the arm, whereas and in patients 3 and 4 minced ovarian tissue was placed into a muscle pocket in the abdominal wall. In patients 1, 2, and 4 the ovarian hormone secretion (as suggested by sequential estradiol and FSH serum measurements) was reestablished 3–4 months after autotransplantation, and graft function was not improved by immediate rather than delayed heterotopic ovarian autografting. Despite a reestablished ovarian function, a 2- to 7-fold increase in peripheral FSH concentration was evidenced. The cases reported here suggest that hormonal protection can be restored after fresh or cryopreserved heterotopic ovarian transplantation in women, albeit for only a short reproductive span.

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