Ovarian tissue cryopreservation and transplantation prevents iatrogenic premature ovarian insufficiency: first 10 cases in China

Abstract

Objective

The aim of this study was to report on the first 10 cases of ovarian tissue cryopreservation (OTC) and retransplantation (OTCT) in China.

Methods

A retrospective descriptive study was performed of 10 Chinese women with different diseases undergoing OTC/OTCT in the first specialized center in China. Patients’ ovarian function and fertility were followed up.

Results

The 10 cases included five cases of cervical cancer and one case each of endometrial cancer, breast cancer, rectal cancer, myelodysplastic syndrome, and aplastic anemia, respectively. The average age at OTC was 33.70 years; the time from OTC to OTCT was 15 months. The average number of transplanted ovarian tissue pieces was 4.9, with 9.5 pieces remaining cryopreserved. The OTCT position for nine cases was in a right-sided peritoneal pocket of ovarian fossa, and for one patient was in bilateral pockets. The average time from OTCT to restoration of ovarian function was 3.4 months. One year after OTCT, all ovaries were still functioning normally. In the first case, the function now remains preserved for more than 3 years. So far, the woman who wishes to conceive has no pregnancy.

Conclusion

Regarding ovarian function, OTC and OTCT were successful and reliable in China’s first cryobank. We expect to perform more retransplantations in the near future, which will add to the global data.

摘要

目的：研究中国单中心最早10例卵巢组织冻存与移植（Ovarian tissue cryopreservation and transplantation, OTCT）患者病例。方法：回顾性描述性研究中国首个卵巢组织冻存库前10例进行OTCT的患者, 后续随访患者的卵巢功能和生育力。结果：10例患者中宫颈癌5例, 子宫内膜癌、乳腺癌、直肠癌、骨髓增生异常综合征、再生障碍性贫血各1例。卵巢组织冻存时患者的平均年龄是33.70岁, 从卵巢组织冻存到卵巢组织移植的时间平均是15个月。卵巢组织移植的片数平均是4.9片, 剩余冻存的组织片数平均是9.5片。9例患者卵巢组织移植于右侧卵巢窝对应的腹膜袋内, 1例移植于双侧卵巢窝对应的腹膜袋内。卵巢组织移植至卵巢功能恢复的时间平均为3.4个月。卵巢组织移植一年后, 所有卵巢功能仍正常。首例患者至今卵巢功能良好, 超过了3年。到目前为止, 有妊娠意愿的女性还没有怀孕。结论：在中国首个卵巢组织冻存库中, 卵巢组织冻存与移植在恢复卵巢功能方面是成功和可靠的。我们希望在不久的将来进行更多的卵巢组织移植, 这将增加全球数据。

Keywords:

• Ovarian tissue cryopreservation
• ovarian tissue retransplantation
• fertility preservation
• premature ovarian insufficiency
• slow freezing
• ovarian tissue transportation

Acknowledgements

All authors thank Prof. Markus Montag (ilabcomm GmbH, Sankt Augustin, Germany) and Dr Jana Liebenthron (University Duesseldorf, Germany) for helping the Beijing Obstetrics and Gynecology Hospital, Capital Medical University to establish China’s first ovarian tissues cryobank, and monitor the innovative technology at least annually. All authors especially also thank Prof. Matthias Korell (coauthor) for helping successfully in the 10 cases with respect to the surgeries.

Potential conflict of interest

The authors disclose no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Source of funding

This study was supported by Beijing Municipal Administration of Hospitals Clinical Medicine, Development of Special Funding Support [code: XMLX201710]; Beijing Municipal Administration of Hospitals’ Ascent Plan [code: DFL20181401]; Beijing Natural Science Foundation [code: 7202047].