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Comparison between slow freezing and vitrification of ovarian tissue cryopreservation in assigned female at birth transgender people receiving testosterone therapy: data on histological and viability parameters

  • Fertility Preservation
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Abstract

Purpose

The use of fertility preservation (FP) techniques has significantly increased in recent years in the assigned female at birth (AFAB) transgender population. Oocyte cryopreservation is the established method for FP, but ovarian tissue cryopreservation may be considered an alternative option, especially during gender-affirming surgery (GAS). The slow freezing (SF) cryopreservation technique is the standard method for human ovarian tissue, but recently, several studies have shown good results with the vitrification (VT) technique. The objective of this study was to compare the effectiveness of VT and SF techniques in ovarian tissue from AFAB transgender people.

Methods

This was a prospective study including 18 AFAB transgender people after GAS. Ovarian tissue pieces from each ovary were cryopreserved by SF and VT and compared with fresh tissue. Study by light microscopy (LM) assessed follicular morphology and density. The percentage of surviving and degenerated follicles was studied with the tissue viability test. Oocytes, granulosa cells and stroma were analysed separately by transmission electron microscopy.

Results

The VT technique preserves follicle and stromal tissue as well as the SF method, but with some differences. Evaluation by LM showed better follicle preservation with VT, but the ultrastructural study showed the presence of minor damage with both techniques compared to fresh tissue.

Conclusion

Both cryopreservation techniques are accurate for maintaining the follicular population and stromal tissue. Further studies are needed to determine the impact of VT on ovarian tissue and the subsequent follicular activation mechanisms in AFAB ovarian tissue.

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  1. Committee Opinion No685. care for transgender adolescents. Obstet Gynecol. 2017;129(1):e11–6. https://doi.org/10.1097/AOG.0000000000001861.

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Funding

This study was supported by the grant “Premi Fi de Residencia Emili Letang 2011” from the Hospital Clinic of Barcelona and the grant “Fundación Dexeus Salud de la Mujer” in 2013–2015.

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Authors and Affiliations

  1. Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036, Barcelona, Spain

    Aina Borrás, Dolors Manau, Francesc Fabregues, Sara Peralta, Josep Maria Calafell, Gemma Casals, Inés Agustí & Francisco Carmona

  2. Department of Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain

    Adela Saco

  3. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    Dolors Manau, Francesc Fabregues, Gemma Casals, Adela Saco & Francisco Carmona

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  1. Aina Borrás
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Contributions

All authors contributed to the study conception and design. Material preparation was performed by Josep Maria Calafell, Adela Saco and Aina Borrás. Data collection and analysis were performed by Aina Borrás, Inés Agustí, Sara Peralta and Gemms Casals. The original draft preparation was performed by Aina Borrás. The study supervision was performed by Dolors Manau, Francesc Fabregues and Francisco Carmona. All authors commented on previous versions of the manuscript and approved the final version of article submitted.

Corresponding author

Correspondence to Aina Borrás.

Ethics declarations

It was conducted according to the Declaration of Helsinki for Medical Research involving Human Subjects [19]. The study protocol was approved by the Ethics Committee of the Hospital Clinic of Barcelona (registry number 2011/6272) in 2011. All subjects provided written, informed consent to participate in the study.

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The authors declare no competing interests.

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Borrás, A., Manau, D., Fabregues, F. et al. Comparison between slow freezing and vitrification of ovarian tissue cryopreservation in assigned female at birth transgender people receiving testosterone therapy: data on histological and viability parameters. J Assist Reprod Genet 39, 527–541 (2022). https://doi.org/10.1007/s10815-021-02386-9

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