Skip to main content

Techniques of Ovarian Transplantation

  • Chapter
  • First Online:
Female and Male Fertility Preservation
  • 1273 Accesses

Abstract

Since the birth of the first baby after auto-transplantation of frozen-thawed ovarian tissue in 2004, several groups have reported worldwide their experience with this technique. Despite the surgical heterogeneity present among these groups, several fundamental principles apply to all of them, which make in turn success rates stable: vascularization, reduction of ischemia time, and placement of fragments.

Although most groups have worked with slow-freezing, it is very likely that vitrification could replace the former because of its simplicity and equivalent results. Several groups are working on different research areas to improve follicle survival and OCT performance. Growth factors, hormones, matrix scaffolds, and robotics surgery may await the future of this young yet stablished fertility preservation procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AMH:

Anti-Müllerian hormone

OCC:

Ovarian cortex cryopreservation

OCT:

Ovarian cortex transplantation

References

  1. Donnez PJ, Dolmans MM, Demylle D, Jadoul P, Pirard C, Squifflet J, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet. 2004; https://doi.org/10.1016/S0140-6736(04)17222-X.

  2. Donnez J, Manavella DD, Dolmans MM. Techniques for ovarian tissue transplantation and results. Minerva Ginecol. 2018;70(4):424–31. https://doi.org/10.23736/S0026-4784.18.04228-4

    PubMed  Google Scholar 

  3. 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; https://doi.org/10.1210/endo.140.1.6453.

  4. Dolmans MM, Martinez-Madrid B, Gadisseux E, Guiot Y, Yuan WY, Torre A, et al. Short-term transplantation of isolated human ovarian follicles and cortical tissue into nude mice. Reproduction. 2007; https://doi.org/10.1530/REP-07-0131.

  5. Nisolle M, Casanas-Roux F, Qu J, Motta P, Donnez J. Histologic and ultrastructural evaluation of fresh and frozen-thawed human ovarian xenografts in nude mice. Fertil Steril. 2000; https://doi.org/10.1016/S0015-0282(00)00548-3.

  6. Gavish Z, Peer G, Hadassa R, Yoram C, Meirow D. Follicle activation and “burn-out” contribute to post-transplantation follicle loss in ovarian tissue grafts: the effect of graft thickness. Hum Reprod. 2014; https://doi.org/10.1093/humrep/deu015.

  7. Gavish Z, Spector I, Peer G, Schlatt S, Wistuba J, Roness H, Meirow D. Follicle activation is a significant and immediate cause of follicle loss after ovarian tissue transplantation. J Assist Reprod Genet. 2018; https://doi.org/10.1007/s10815-017-1079-z.

  8. Amorim CA, Curaba M, Van Langendonckt A, Dolmans MM, Donnez J. Vitrification as an alternative means of cryopreserving ovarian tissue. Reprod Biomed Online. 2011; https://doi.org/10.1016/j.rbmo.2011.04.005.

  9. Kawamura K, Cheng Y, Suzuki N, Deguchi M, Sato Y, Takae S, et al. Hippo signaling disruption and Akt stimulation of ovarian follicles for infertility treatment. Proc Natl Acad Sci. 2013; https://doi.org/10.1073/pnas.1312830110.

  10. Suzuki N, Yoshioka N, Takae S, Sugishita Y, Tamura M, Hashimoto S, et al. Successful fertility preservation following ovarian tissue vitrification in patients with primary ovarian insufficiency. Hum Reprod. 2015; https://doi.org/10.1093/humrep/deu353.

  11. Sanfilippo S, Canis M, Smitz J, Sion B, Darcha C, Janny L, Brugnon F. Vitrification of human ovarian tissue: a practical and relevant alternative to slow freezing. Reprod Biol Endocrinol. 2015; https://doi.org/10.1186/s12958-015-0065-5.

  12. Oktay K, Karlikaya G. Ovarian function after transplantation of frozen, banked autologous ovarian tissue. N Engl J Med. 2000;342(25):1919. https://doi.org/10.1056/NEJM200006223422516.

    Article  CAS  PubMed  Google Scholar 

  13. Donnez J, Jadoul P, Pirard C, Hutchings G, Demylle D, Squifflet J, et al. Live birth after transplantation of frozen-thawed ovarian tissue after bilateral oophorectomy for benign disease. Fertil Steril. 2012; https://doi.org/10.1016/j.fertnstert.2012.05.017.

  14. von Wolff, M., Germeyer, A., Liebenthron, J., Korell, M., Nawroth, F., (2018). Practical recommendations for fertility preservation in women by the FertiPROTEKT network. Part II: fertility preservation techniques. Arch Gynecol Obstet. https://doi.org/10.1007/s00404-017-4595-2 LK - http://sfx.library.uu.nl/utrecht?sid=EMBASE&issn=14320711&id=doi:10.1007%2Fs00404-017-4595-2&atitle=Practical+recommendations+for%C2%A0fertility+preservation+in+women+by+the+FertiPROTEKT+network.+Part+II%3A+fertility+preservation+techniques&stitle=Arch.+Gynecol.+Obstet.&title=Archives+of+Gynecology+and+Obstetrics&volume=297&issue=1&spage=257&epage=267&aulast=von+Wolff&aufirst=Michael&auinit=M.&aufull=von+Wolff+M.&coden=AGOBE&isbn=&pages=257-267&date=2018&auinit1=M

  15. Kim SS. Assessment of long term endocrine function after transplantation of frozen-thawed human ovarian tissue to the heterotopic site: 10 year longitudinal follow-up study. J Assist Reprod Genet. 2012; https://doi.org/10.1007/s10815-012-9757-3.

  16. Kim SS. Revisiting the role of heterotopic ovarian transplantation: futility or fertility. Reprod Biomed Online. 2014; https://doi.org/10.1016/j.rbmo.2013.09.028.

  17. Stern CJ, Gook D, Hale LG, Agresta F, Oldham J, Rozen G, Jobling T. First reported clinical pregnancy following heterotopic grafting of cryopreserved ovarian tissue in a woman after a bilateral oophorectomy. Hum Reprod. 2013; https://doi.org/10.1093/humrep/det360.

  18. Tammiste T, Kask K, Padrik P, Idla K, Rosenstein K, Jatsenko T, et al. A case report and follow-up of the first live birth after heterotopic transplantation of cryopreserved ovarian tissue in Eastern Europe. BMC Womens Health. 2019;19(1):65. https://doi.org/10.1186/s12905-019-0764-8.

    Article  PubMed  PubMed Central  Google Scholar 

  19. 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; https://doi.org/10.1016/j.fertnstert.2008.04.019.

  20. Silber S. How ovarian transplantation works and how resting follicle recruitment occurs: a review of results reported from one center. Womens Health. 2016; https://doi.org/10.2217/whe.15.108.

  21. Silber SJ. Ovary cryopreservation and transplantation for fertility preservation. Mol Hum Reprod. 2012; https://doi.org/10.1093/molehr/gar082.

  22. Silber SJ, Derosa M, Pineda J, Lenahan K, Grenia D, Gorman K, Gosden RG. A series of monozygotic twins discordant for ovarian failure: ovary transplantation (cortical versus microvascular) and cryopreservation. Hum Reprod. 2008; https://doi.org/10.1093/humrep/den032.

  23. Silber SJ, Lenahan KM, Levine DJ, Pineda JA, Gorman KS, Friez MJ, et al. Ovarian transplantation between monozygotic twins discordant for premature ovarian failure. Obstet Gynecol Surv. 2006; https://doi.org/10.1097/01.ogx.0000193856.67237.f1.

  24. Meirow D, Levron J, Eldar-Geva T, Hardan I, Fridman E, Zalel Y, et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med. 2005; https://doi.org/10.1056/nejmc055237.

  25. Andersen CY, Rosendahl M, Byskov AG, Loft A, Ottosen C, Dueholm M, et al. Two successful pregnancies following autotransplantation of frozen/thawed ovarian tissue. Hum Reprod. 2008; https://doi.org/10.1093/humrep/den244.

  26. Donnez J, Dolmans MM, Pellicer A, Diaz-Garcia C, Sanchez Serrano M, Schmidt KT, et al. Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue: a review of 60 cases of reimplantation. Fertil Steril. 2013;99:1503–13. https://doi.org/10.1016/j.fertnstert.2013.03.030.

    Article  Google Scholar 

  27. Donnez J, Dolmans M-M. Fertility preservation in women. N Engl J Med. 2017;377(17):1657–65. https://doi.org/10.1056/NEJMra1614676.

    Article  PubMed  Google Scholar 

  28. 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):1167–70. https://doi.org/10.1007/s10815-015-0544-9.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Meirow D, Roness H, Kristensen SG, Andersen CY. Optimizing outcomes from ovarian tissue cryopreservation and transplantation; activation versus preservation. Hum Reprod. 2015;30(11):2453–6. https://doi.org/10.1093/humrep/dev210.

    Article  PubMed  Google Scholar 

  30. Oktay K, Taylan E, Kawahara T, Cillo GM. Robot-assisted orthotopic and heterotopic ovarian tissue transplantation techniques: surgical advances since our first success in 2000. Fertil Steril. 2019;111(3):604–6. https://doi.org/10.1016/j.fertnstert.2018.11.042.

    Article  PubMed  Google Scholar 

  31. Oktay K, Bedoschi G, Pacheco F, 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; https://doi.org/10.1016/j.ajog.2015.10.001.

  32. Shikanov A, Shea LD, Smith RM, Rajan A, Zhang Z, Xu M, Woodruff TK. Fibrin encapsulation and vascular endothelial growth factor delivery promotes ovarian graft survival in mice. Tissue Eng Part A. 2011; https://doi.org/10.1089/ten.TEA.2011.0204.

  33. Man L, Park L, Bodine R, Ginsberg M, Zaninovic N, Man OA, et al. Engineered endothelium provides angiogenic and paracrine stimulus to grafted human ovarian tissue. Sci Rep. 2017; https://doi.org/10.1038/s41598-017-08491-z.

  34. Damous, L. L., Nakamuta, J. S., Saturi de Carvalho, A. E. T., Carvalho, K. C., Soares, J. M. Jr, Manuel de Jesus Simões., … Baracat, E. C. (2015). Scaffold-based delivery of adipose tissue-derived stem cells in rat frozen-thawed ovarian autografts: preliminary studies in a rat model. J Assist Reprod Genet https://doi.org/10.1007/s10815-015-0527-x.

  35. Dolmans MM, Cacciottola L, Amorim CA, Manavella D. Translational research aiming to improve survival of ovarian tissue transplants using adipose tissue-derived stem cells. Acta Obstet Gynecol Scand. 2019;98(5):665–71. https://doi.org/10.1111/aogs.13610.

    Article  CAS  PubMed  Google Scholar 

  36. Zhang Y, Xia X, Yan J, Yan L, Lu C, Zhu X, et al. Mesenchymal stem cell-derived angiogenin promotes primodial follicle survival and angiogenesis in transplanted human ovarian tissue. Reprod Biol Endocrinol. 2017;15(1):18. https://doi.org/10.1186/s12958-017-0235-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Takae S, Suzuki N. Current state and future possibilities of ovarian tissue transplantation. Reprod Med Biol. 2019;18:217–24. https://doi.org/10.1002/rmb2.12268.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Takae S, Tsukada K, Maeda I, Okamoto N, Sato Y, Kondo H, et al. Preliminary human application of optical coherence tomography for quantification and localization of primordial follicles aimed at effective ovarian tissue transplantation. J Assist Reprod Genet. 2018; https://doi.org/10.1007/s10815-018-1166-9.

  39. Peters ITA, Stegehuis PL, Peek R, Boer FL, van Zwet EW, Eggermont J, et al. Noninvasive detection of metastases and follicle density in ovarian tissue using full-field optical coherence tomography. Clin Cancer Res. 2016;22(22):5506–13. https://doi.org/10.1158/1078-0432.CCR-16-0288.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Subirá, J. (2022). Techniques of Ovarian Transplantation. In: Grynberg, M., Patrizio, P. (eds) Female and Male Fertility Preservation. Springer, Cham. https://doi.org/10.1007/978-3-030-47767-7_33

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-47767-7_33

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47766-0

  • Online ISBN: 978-3-030-47767-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics