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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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