Ovarian tissue freezing followed by transplantation is a revolutionary approach to preserving fertility in women diagnosed with cancer. In post-pubertal females, the ovarian tissue freezing procedure can be performed regardless of the day of the menstrual cycle, obviating a delay in cancer treatment. Ovarian tissue cryopreservation (freezing) does not require sexual maturity, making it an option for children at risk of losing their fertility who eventually want to become mothers.
Kutluk Oktay, MD, the world’s leading expert in fertility preservation pioneered ovarian transplantation, having performed the first ovarian transplant with cryopreserved tissue in 1999 (Marin L, Bedoschi G, Kawahara T, Oktay KH. History, Evolution and Current State of Ovarian Tissue Auto-Transplantation with Cryopreserved Tissue: a Successful Translational Research Journey from 1999 to 2020. Reprod Sci. 2020 Apr;27(4):955-962. doi: 10.1007/s43032-019-00066-9. Epub 2020 Jan 6. PMID: 32046442; PMCID: PMC7148200.). Through his New York City practice Innovation Fertility Preservation & IVF, Dr. Oktay uses cutting-edge fertility treatments, including ovarian cryopreservation and transplantation, to help couples and individuals realize their dream of starting or expanding their family.
In this post, we discuss more details about ovarian tissue freezing and transplantation and the likelihood of a successful pregnancy after performing the procedure.
Ovarian cryopreservation and transplantation is an option for women and young girls at risk of losing fertility because of cancer treatments. The procedure involves harvesting ovarian tissue by removing part or whole of an ovary and then freezing the outer layer of the ovary (called cortex) which can contain hundreds of thousands of immature eggs in slivers of the tissue through a highly specialized process. The cryopreserved tissue is then stored in liquid nitrogen. There is no time limit for storage and successful pregnancies have occurred even after decades long storage.
When a woman is ready to have children, the ovarian tissues are thawed and transplanted back into the woman to restore fertility. To perform the transplantation, Dr. Oktay thaws and implants the slivers of tissue into the remaining ovary with a robotic surgical technique that he developed (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 Jan;214(1):94.e1-9. doi: 10.1016/j.ajog.2015.10.001. Epub 2015 Nov 18. PMID: 26601616; PMCID: PMC4707043.). The grafted tissue then regains its blood supply from the recipient's ovary. If the patient does not have a remaining ovary, Dr. Oktay developed other surgical techniques, where the tissues can be implanted into the pelvic sidewall or the abdominal wall (Christianson MS, Oktay K. Advances in fertility-preservation surgery: navigating new frontiers. Fertil Steril. 2019 Sep;112(3):438-445. doi: 10.1016/j.fertnstert.2019.06.029. PMID: 31446903.).
Dr. Oktay’s research showed that, worldwide, about 70% of the ovarian transplants result in the restoration of reproductive hormone production (fPacheco F, Oktay K. Current Success and Efficiency of Autologous Ovarian Transplantation: A Meta-Analysis. Reprod Sci. 2017 Aug;24(8):1111-1120. doi: 10.1177/1933719117702251. Epub 2017 Jul 13. PMID: 28701069): . In the case of Dr. Oktay’s own case series, this rate is 100%.
Dr. Oktay’s research showed that the worldwide average of success rates with the transplantation of cryopreserved ovarian tissue is around 40% ((Pacheco F, Oktay K. Current Success and Efficiency of Autologous Ovarian Transplantation: A Meta-Analysis. Reprod Sci. 2017 Aug;24(8):1111-1120. doi: 10.1177/1933719117702251. Epub 2017 Jul 13. PMID: 28701069).
In the currently unpublished case series of Dr. Oktay, >70% of the transplant recipients who are intending pregnancy had at least one child, or stored genetically normal embryos (tested with PGT-A) with high chance of livebirth from the eggs collected from their transplants.
Ovarian tissue cryopreservation followed by transplantation is a life-changing option that gives women and young girls diagnosed with cancer the chance to have their own children. Given its success with cancer patients, it is now also offered for women who wish to delay childbearing or menopause (Oktay KH, Marin L, Petrikovsky B, Terrani M, Babayev SN. Delaying Reproductive Aging by Ovarian Tissue Cryopreservation and Transplantation: Is it Prime Time? Trends Mol Med. 2021 Feb 3:S1471-4914(21)00036-8. doi: 10.1016/j.molmed.2021.01.005. Epub ahead of print. PMID: 33549473.)
Rest assured that Dr. Oktay and our team will provide the guidance and support you need every step of the way when considering ovarian tissue cryopreservation and transplantation. To learn more about this cutting-edge option, call our New York City office to schedule your initial consultation with Dr. Oktay or book your appointment online today.