Operative techniques and complications of extraction and transplantation of ovarian tissue: the Erlangen experience
Extracting ovarian tissue before oncologic therapy and transplanting it afterwards are increasingly being used to preserve fertility in women. This study describes standardized and safe operative procedures, with few complications, and reports the resulting ovarian function and pregnancy rates.
The standardized operative techniques for removing and transplanting ovarian tissue used at the Erlangen center are: for tissue removal, one-third to half of the tissue from one ovary is excised with scissors, without tissue coagulation; for subsequent transplantation, pieces of ovarian tissue are placed in a retroperitoneal pocket without closure of the pocket.
Between January 2007 and December 2015, ovarian tissue was extracted in 399 women and transplanted following cancer therapy in 38. No surgical complications were observed within 28 days. To date, there have been ten pregnancies and nine live births after transplantation in seven different women; 26 of the 38 women developed hormonal activity, confirmed by a menstrual cycle or raised serum estradiol levels.
The techniques for laparoscopic removal and transplantation of ovarian tissue described here provide a standardized method with a very low risk of complications. The pregnancy rate after ovarian tissue transplantation, currently 15–30%, can be expected to rise further in the near future.
KeywordsFertility preservation Oncofertility Surgical techniques Ovarian tissue extraction Ovarian tissue transplantation
MWB: idea, conception of the manuscript, manuscript correction. RD: conception of the manuscript, figure creation, manuscript correction. LL: supervision, support in literature search. PGO: supervision. SF: literature analysis, data collection, preparation of the manuscript. TH: supervision. KH: supervision. SC: supervision. AM: supervision, figure creation.
Compliance with ethical standards
Conflict of interest
The authors report no conflict of interest.
Research involving human participants and/or animals
For our study, neither humans nor animals had been involved.
An informed consent was not necessary as there were no humans being involved into interventions.
There is no study funding.
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