Cancer and ovarian tissue cryopreservation

Although ovarian tissue cryopreservation is still accepted as an experimental procedure, it has recently become an increasingly resorted technique in highly specialized in vitro fertilization (IVF) clinics. Its indications include many childhood cancers, breast cancer, some autoimmune diseases, hematopoietic stem cell transplantation, and pelvic radiation therapy due to solid tumors. The chemotherapeutics and radiation therapy may diminish ovarian reserve and cause premature ovarian failure. It currently seems as the only option for fertility preservation in children where ovulation induction is ethically not acceptable, and for those when cytotoxic therapy is urgent. There are 2 main methods for transplantation of frozen-thawed ovarian tissues: orthotopic and heterotopic transplantation. Together with its advantages,this method also has some risks, such as reimplantation of the primary tumor, malignant transformation, and loss offollicles. Therefore, a thorough counseling should be provided before going forward with the procedure. Although it is still an experimental method, there are 7 reports of live births after ovarian tissue cryopreservation. In this review,technical details of ovarian tissue cryopreservation, related indications, and methods of ovarian tissue transplantation are discussed and an algorithmic approach to fertility preservation is presented.