Innovation Fertility Preservation and IVF
Kutluk Oktay, MD, PhD, FACOG
Infertility & Fertility Preservation Specialist located in New York, NY & New Haven, CT
Dr. Oktay developed and performed the world’s first ovarian tissue freezing and transplantation procedures, as he’s one of the world’s leading experts on the topic. At Innovation Fertility Preservation and IVF, Dr. Kutluk Oktay and his highly trained staff perform the most advanced techniques of ovarian tissue cryopreservation (freezing) and transplantation, which they developed for both children and adults. Dr. Oktay and his staff provide these and other services at one location: New York, New York. Patients are encouraged to visit the facility, or set up a Skype or phone consultation, to discuss their eligibility with Dr. Oktay and his staff.
Ovarian Tissue Freezing and Transplant Q & A
What is the primary function of the ovaries?
The ovaries are responsible for both the production of the female hormones (estrogen and progesterone), as well as the production of the eggs that are needed to conceive. Women are born with about 1 million immature eggs called primordial follicles that are stored in the outer layer of both ovaries. Many of these start their growths every day and last for many months. In the end, only one egg makes it to ovulation, leaving 99.9% of eggs to be wasted in a lifetime.
By freezing ovarian tissue, you can preserve hundreds of thousands of these surplus eggs for future use. Even after you've passed your childbearing years, your ovaries are still at work, releasing an ever-decreasing amount of female hormones. As the levels of hormones decrease, your body begins to change. This transition is referred to as peri-menopause and can last for several years. It's at this point that a patient's eggs are no longer considered of value when it comes to cryopreservation or fertility options.
Why is ovarian tissue frozen?
Dr. Oktay freezes ovarian tissue as a means of preserving your ability to produce children at a later date. Because ovarian tissue freezing preserves immature eggs called primordial follicles, an ovary can be harvested from any age girl if she’s been diagnosed with the condition, or is expected to receive a treatment that may later affect her ability to have children.
Ovarian tissue freezing doesn’t require ovarian stimulation, and you can complete it within a few days. That's crucial in case you need to start any cancer or other medical/surgical treatments soon.
Dr. Oktay harvests ovarian tissue via a keyhole or robot-assisted surgery, which is an outpatient procedure lasting less than an hour, and requiring only tiny incisions. Once he has harvested the ovarian tissue, the outer shell is cut into thin strips and frozen. This outer strip contains hundreds of thousands of immature eggs, and once transplanted, results in the reversal of menopause and the restoration of natural fertility.
Dr. Oktay’s special robotically-assisted transplant technique resulted in numerous live births. Dr. Oktay’s feature in this article further delves into his contribution to the study of ovarian tissue freezing.
How long does ovarian tissue remain viable once it is frozen?
Much like with eggs that have been cryopreserved, ovarian tissues can last indefinitely in the right type of storage. Tissues that have undergone cryopreservation are sealed in a container and stored around -320 degrees Fahrenheit.
Dr. Oktay's research has revealed that there aren’t many eggs lost during the freezing and thawing process, but it must be done by using the right techniques. He has developed proprietary techniques to ensure most successful ovarian tissue freezing.
Who should freeze their ovarian tissues?
Dr. Oktay recommends cryopreservation for several reasons. These may include:
- Medical treatments such as chemotherapy, radiation or radical surgery that irreversibly damage or remove ovarian follicles (egg reserve) in ovaries of children and adult females
- Genetic and autoimmune conditions that can cause premature menopause
- Elective reasons to postpone childbearing
- Strong family history of premature ovarian failure and early menopause
Click here to read more about elective ovarian tissue freezing.
Who is a good candidate for an ovarian transplant?
Ovarian transplants are ideal for:
- Women who had frozen ovarian tissue before cancer treatment survived cancer, and are healthy to have children
- Women who have frozen ovarian tissue because of their genetic tendency for early menopause and want to have children
- Single women who have frozen ovarian tissue for delaying childbearing, and are now ready to have children
- Women who have previously frozen ovarian tissues and want to reverse menopause.
In general, Dr. Oktay recommends that women to be ready to have children before transplanting their tissue back. That's because once the ovarian tissue is transplanted, the clock starts ticking. It’s hard to predict how long the graft would last. In many instances, once the graft functions, Dr. Oktay first performs IVF to generate and freeze embryos, in case the graft stops functioning, and the patient wishes to have multiple children in the future.
Ovarian tissue can be harvested as a child, preserving the tissue for many years. Once the child reaches adulthood and decides to attempt a pregnancy, Dr. Oktay can thaw a portion of the tissue and transplant it back into her body.
What is involved in an ovarian transplant?
An ovarian transplant is a procedure that Dr. Oktay developed. He’s the first person in the world to perform ovarian transplants with frozen tissue.
First, during an ovarian transplant, Dr. Oktay uses a technique to reconstruct the small pieces of ovarian tissues on a tissue scaffold under a microscope.This scaffold is then transplanted back into the body with a robot-assisted laparoscopic procedure. Once in place, the ovarian graft will begin to reestablish connections with blood vessels in the area. This can take anywhere from three to ten days.
Dr. Oktay’s unique technique accelerates this new blood vessel formation and results in increased success. The main reasons ovarian transplants fail is due to the limitations in new blood vessel connections. Performed with a Da Vinci® robot, the procedure allows Dr. Oktay to be precise and exact in where he places the tissues.
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