Concept Paper on the Technique of Cryopreservation, Removal and Transplantation of Ovarian Tissue for Fertility Preservation

Abstract

The cryopreservation of ovarian tissue with subsequent transplantation of the tissue represents an established method of fertility protection for female patients who have to undergo gonadotoxic therapy. The procedure can be performed at any point in the cycle and thus generally does not lead to any delay in oncological therapy. With the aid of this procedure, more than 130 births to date worldwide have been able to be recorded. The birth rate is currently approximately 30% and it can be assumed that this will increase through the further optimisation of the cryopreservation and surgical technique. The concept paper presented here is intended to provide guidance for managing cryopreservation and transplantation of ovarian tissue to German-speaking reproductive medicine centres.

Key words

FertiPROTEKT - fertility protection - ovarian tissue - cryopreservation - transplantation

^* Equal authorship

• References/Literatur

• 1 Fertility preservation for patients with malignant disease. Guideline of the DGGG, DGU and DGRM (S2k-Level, AWMF Registry No. 015/082, November 2017). Online: http://www.awmf.org/leitlinien/detail/ll/015-082.html last access: 13.06.2018
• 2 von Wolff M, Germeyer A, Liebenthron J. et al. Practical recommendations for fertility preservation in women by the FertiPROTEKT network. Part II: fertility preservation techniques. Arch Gynecol Obstet 2018; 297: 257-267
• 3 Winkler-Crepaz K, Bottcher B, Toth B. et al. What is new in 2017? Update on fertility preservation in cancer patients. Minerva Endocrinol 2017; 42: 331-339
• 4 Martinez F. International Society for Fertility Preservation–ESHRE–ASRM Expert Working Group. Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives. Fertil Steril 2017; 108: 407-415.e11
• 5 Practice Committee of American Society for Reproductive Medicine. Ovarian tissue cryopreservation: a committee opinion. Fertil Steril 2014; 101: 1237-1243
• 6 Donnez J, Dolmans MM, Demylle D. et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 364: 1405-1410
• 7 Muller A, Keller K, Wacker J. et al. Retransplantation of cryopreserved ovarian tissue: the first live birth in Germany. Dtsch Arztebl Int 2012; 109: 8-13
• 8 Van der Ven H, Liebenthron J, Beckmann M. et al. Ninety-five orthotopic transplantations in 74 women of ovarian tissue after cytotoxic treatment in a fertility preservation network: tissue activity, pregnancy and delivery rates. Hum Reprod 2016; 31: 2031-2041
• 9 Jensen AK, Macklon KT, Fedder J. et al. 86 successful births and 9 ongoing pregnancies worldwide in women transplanted with frozen-thawed ovarian tissue: focus on birth and perinatal outcome in 40 of these children. J Assist Reprod Genet 2017; 34: 325-336
• 10 Pacheco F, Oktay K. Current Success and Efficiency of Autologous Ovarian Transplantation: A Meta-Analysis. Reprod Sci 2017; 24: 1111-1120
• 11 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: 1167-1170
• 12 Dittrich R, Hackl J, Lotz L. et al. Pregnancies and live births after 20 transplantations of cryopreserved ovarian tissue in a single center. Fertil Steril 2015; 103: 462-468
• 13 Jadoul P, Guilmain A, Squifflet J. et al. Efficacy of ovarian tissue cryopreservation for fertility preservation: lessons learned from 545 cases. Hum Reprod 2017; 32: 1046-1054
• 14 Lotz L, Maktabi A, Hoffmann I. et al. Ovarian tissue cryopreservation and retransplantation – what do patients think about it?. Reprod Biomed Online 2016;
• 15 Gellert SE, Pors SE, Kristensen SG. et al. Transplantation of frozen-thawed ovarian tissue: an update on worldwide activity published in peer-reviewed papers and on the Danish cohort. J Assist Reprod Genet 2018;
• 16 Pacheco F, Oktay K. Current Success and Efficiency of Autologous Ovarian Transplantation: A Meta-Analysis. Reprod Sci 2017; 24: 1111-1120
• 17 von Wolff M, Montag M, Dittrich R. et al. Fertility preservation in women–a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkinʼs lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT. Arch Gynecol Obstet 2011; 284: 427-435
• 18 Dittrich R, Mueller A, Binder H. et al. First retransplantation of cryopreserved ovarian tissue following cancer therapy in Germany. Dtsch Arztebl Int 2008; 105: 274-278
• 19 Wallace WH, Smith AG, Kelsey TW. et al. Fertility preservation for girls and young women with cancer: population-based validation of criteria for ovarian tissue cryopreservation. Lancet Oncol 2014; 15: 1129-1136
• 20 Schuring AN, Fehm T, Behringer K. et al. Practical recommendations for fertility preservation in women by the FertiPROTEKT network. Part I: Indications for fertility preservation. Arch Gynecol Obstet 2018; 297: 241-255
• 21 Jensen AK, Rechnitzer C, Macklon KT. et al. Cryopreservation of ovarian tissue for fertility preservation in a large cohort of young girls: focus on pubertal development. Hum Reprod 2017; 32: 154-164
• 22 Anderson RA, Hindmarsh PC, Wallace WH. Induction of puberty by autograft of cryopreserved ovarian tissue in a patient previously treated for Ewing sarcoma. Eur J Cancer 2013; 49: 2960-2961
• 23 Poirot C, Abirached F, Prades M. et al. Induction of puberty by autograft of cryopreserved ovarian tissue. Lancet 2012; 379: 588
• 24 Demeestere I, Simon P, Dedeken L. et al. Live birth after autograft of ovarian tissue cryopreserved during childhood. Hum Reprod 2015; 30: 2107-2109
• 25 Senthilingam M. Women is first to have baby with ovaries frozen in childhood. CNN-Meldung vom 16. Dezember 2016. Online: http://daebl.de/UX32 last access: 01.05.2018
• 26 Wallace WH, Thomson AB, Saran F. et al. Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys 2005; 62: 738-744
• 27 Beckmann MW, Dittrich R, Lotz L. et al. Fertility protection: complications of surgery and results of removal and transplantation of ovarian tissue. Reprod Biomed Online 2018; 36: 188-196
• 28 Beckmann MW, Dittrich R, Lotz L. et al. Operative techniques and complications of extraction and transplantation of ovarian tissue: the Erlangen experience. Arch Gynecol Obstet 2017; 295: 1033-1039
• 29 Beckmann MW, Dittrich R, Findeklee S. et al. Surgical Aspects of Ovarian Tissue Removal and Ovarian Tissue Transplantation for Fertility Preservation. Geburtsh Frauenheilk 2016; 76: 1057-1064
• 30 von Wolff M, Dittrich R, Liebenthron J. et al. Fertility-preservation counselling and treatment for medical reasons: data from a multinational network of over 5000 women. Reprod Biomed Online 2015; 31: 605-612
• 31 Rosendahl M, Simonsen MK, Kjer JJ. The influence of unilateral oophorectomy on the age of menopause. Climacteric 2017; 20: 540-544
• 32 Liebenthron J, Montag M. Chapter 15 Development of a Nationwide Network for Ovarian Tissue Cryopreservation. Methods Mol Biol 2017; 1568: 205-220
• 33 Schmidt KL, Ernst E, Byskov AG. et al. Survival of primordial follicles following prolonged transportation of ovarian tissue prior to cryopreservation. Hum Reprod 2003; 18: 2654-2659
• 34 Dittrich R, Lotz L, Keck G. et al. Live birth after ovarian tissue autotransplantation following overnight transportation before cryopreservation. Fertil Steril 2012; 97: 387-390
• 35 Klocke S, Tappehorn C, Griesinger G. Effects of supra-zero storage on human ovarian cortex prior to vitrification-warming. Reprod Biomed Online 2014; 29: 251-258
• 36 Rosendahl M, Timmermans Wielenga V, Nedergaard L. et al. Cryopreservation of ovarian tissue for fertility preservation: no evidence of malignant cell contamination in ovarian tissue from patients with breast cancer. Fertil Steril 2011; 95: 2158-2161
• 37 Gastal GD, Alves BG, Alves KA. et al. Ovarian fragment sizes affect viability and morphology of preantral follicles during storage at 4 degrees C. Reproduction 2017; 153: 577-587
• 38 Dittrich R, Lotz L, Keck G. et al. Live birth after ovarian tissue autotransplantation following overnight transportation before cryopreservation. Fertil Steril 2012; 97: 387-390
• 39 Bastings L, Liebenthron J, Westphal JR. et al. Efficacy of ovarian tissue cryopreservation in a major European center. J Assist Reprod Genet 2014; 31: 1003-1012
• 40 Rodriguez-Wallberg KA, Tanbo T, Tinkanen H. et al. Ovarian tissue cryopreservation and transplantation among alternatives for fertility preservation in the Nordic countries – compilation of 20 years of multicenter experience. Acta Obstet Gynecol Scand 2016; 95: 1015-1026
• 41 Meirow D, Roness H, Kristensen SG. et al. Optimizing outcomes from ovarian tissue cryopreservation and transplantation; activation versus preservation. Hum Reprod 2015; 30: 2453-2456
• 42 Shi Q, Xie Y, Wang Y. et al. Vitrification versus slow freezing for human ovarian tissue cryopreservation: a systematic review and meta-anlaysis. Sci Rep 2017; 7: 8538
• 43 Donnez J, Dolmans MM. Ovarian tissue freezing: current status. Curr Opin Obstet Gynecol 2015; 27: 222-230
• 44 Gosden RG, Baird DT, Wade JC. et al. Restoration of fertility to oophorectomized sheep by ovarian autografts stored at − 196 degrees C. Hum Reprod 1994; 9: 597-603
• 45 Newton H, Aubard Y, Rutherford A. et al. Low temperature storage and grafting of human ovarian tissue. Hum Reprod 1996; 11: 1487-1491
• 46 Bastings L, Westphal JR, Beerendonk CC. et al. Clinically applied procedures for human ovarian tissue cryopreservation result in different levels of efficacy and efficiency. J Assist Reprod Genet 2016; 33: 1605-1614
• 47 Dolmans MM, Jadoul P, Gilliaux S. et al. A review of 15 years of ovarian tissue bank activities. J Assist Reprod Genet 2013; 30: 305-314
• 48 Donnez J, Dolmans MM, Pellicer A. 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: 1503-1513
• 49 Donnez J, Dolmans MM. Transplantation of ovarian tissue. Best Pract Res Clin Obstet Gynaecol 2014; 28: 1188-1197
• 50 von Wolff M, Dittrich R, Stute P. Transplantation of ovarian tissue to postpone menopause – is it really more advantageous for womenʼs health than menopause hormone therapy?. Reprod Biomed Online 2015; 31: 827
• 51 Rodriguez-Wallberg KA, Tanbo T, Tinkanen H. et al. Ovarian tissue cryopreservation and transplantation among alternatives for fertility preservation in the Nordic countries – compilation of 20 years of multicenter experience. Acta Obstet Gynecol Scand 2016; 95: 1015-1026
• 52 Cobo A, Garrido N, Crespo J. et al. Accumulation of oocytes: a new strategy for managing low-responder patients. Reprod Biomed Online 2012; 24: 424-432