A new technique to protect ovarian function before pelvic irradiation: Heterotopic ovarian autotransplantation

Abstract

The authors describe a new technique for the subcutaneous heterotopic transplantation of the ovary before pelvic irradiation to treat Hodgkin's disease. Creation of a cavity to receive the transplant and the use of two surgical teams and the surgical microscope during the operation ensured its successful outcome. The transplanted ovary was followed up clinically and by ultrasound monitoring: ovarian cycles remained regular despite radiotherapy, and follicle growth occurred normally. In comparison to other types of oophoropexy described in the literature, the advantages of this technique included total protection of the ovary from irradiation, and conservation of ovarian function and fertility. One year after the procedure, puncture of the ovarian compartment produced a mature oocyte specimen.

The human postmenopausal ovary as a tool for evaluation of cryopreservation protocols towards whole ovary cryopreservation

“…The microsurgical vascular anastomoses of the human ovarian arteries and veins is achievable as illustrated by successful heterotopic auto-transplantation [7,8] and orthotopic transplantation between monozygotic twins [9]. A live birth was reported by the latter method [9].…”

Optimizing cryoprotectant perfusion conditions for intact ovary: a bovine model

“…Thus far, five reports have described fresh whole ovary grafts with vascular anastomosis in human, and one successful pregnancy was recorded [14,[27][28][29][30][31]. In the past few years, attempts at freezing and grafting whole ovaries in animal have yielded encouraging results.…”

Temporary ovarian transplantation for iatrogenic sterility

“…Since the fragments ovaries become non-functional within a year, they need to be retransplanted as soon as possible; this method permits preservation of all ovarian functions as it is assumed on whole-ovary transplant, and requires no freezing process. While preservation of ovarian function by ovarian t r a n s l o c a t i o n h a s b e e n c l i n i c a l l y p e r f o r m e d (autotransplantation) thus far [6][7][8] , the reproductive dysfunction after TBI (total body irradiation) is inevitable.…”