Ovarian tissue cryopreservation and transplantation: 20 years experience in Bologna University

Raffaella Fabbri; Rossella Vicenti; Valentina Magnani; Roberto Paradisi; Mario Lima; Lucia De Meis; Stefania Rossi; Diego Raimondo; Paolo Casadio; Stefano Venturoli; Michela Maffi; Renato Seracchioli

doi:10.3389/fendo.2022.1035109

Ovarian tissue cryopreservation and transplantation: 20 years experience in Bologna University

Front Endocrinol (Lausanne). 2022 Oct 12:13:1035109. doi: 10.3389/fendo.2022.1035109. eCollection 2022.

Authors

Affiliations

¹ Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
² Department of Medical and Surgical Sciences, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
³ Pediatric Surgery Department, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Bologna, Italy.
⁴ Division of Gynaecology and Human Reproduction Physiopathology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Bologna, Italy.
⁵ Department of Medical and Surgical Sciences, Division of Gynaecology and Human Reproduction Physiopathology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy.

Abstract

Objective: To report the 20-year experience in ovarian tissue cryopreservation (OTC) and ovarian tissue transplantation (OTT) of the Bologna clinical center (Bologna, Italy).

Design: Retrospective cohort study.

Patients: 1026 pediatrics and women aged between 2 and 38 years who underwent OTC and OTT between January 2002 to January 2022.

Results: Of the 1026 patients, 238 (22.8%) were pediatrics (≤ 17 years, Group 1) and 788 (77.2%) were adult women (range 18-38 years, Group 2). In Group 1, 184 (77.3%) patients had malignant diseases and 54 (22.7%) had non-malignant diseases. In Group 2, 746 (94.7%) patients had malignant diseases and 42 (5.3%) had non-malignant diseases. No real complications were observed during surgery. In all the samples analyzed most of the follicles were in the resting stage, while only a few follicles were growing. In both fresh and thawed samples, follicular density was higher in Group 1 than in Group 2 (p < 0.01). Regardless of age, good preservation of follicles and stroma was observed in fresh and thawed ovarian tissue by histological and immunohistochemical analyses (estrogen and progesterone receptors; Ki67 and Bcl2 markers; TUNEL). To date, out of 1026 total women, 812 (79.1%) had their tissue stored. Sixty-eight (6.6%) patients died from their primary disease. Twenty-four (2.3%) women performed 33 OTTs between December 2011 and January 2022. Restoration of menstruation was observed in 15 out of 17 menopausal women. Six pregnancies were achieved, two hesitated in abortion and four in the birth of healthy babies.

Conclusion: OTC is the only fertility preservation technique applicable in pre-pubertal/pediatrics and in adult patients when stimulation for oocytes/embryos cryopreservation is not possible. The reported data can help future patients and physicians in their discussions and decisions about the need and possibilities of preserving ovarian function.

Keywords: cancer; fertility preservation; laparoscopy; ovarian tissue cryopreservation; ovarian tissue transplantation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Cryopreservation / methods
Female
Fertility Preservation* / methods
Humans
Male
Neoplasms* / pathology
Ovary / pathology
Pregnancy
Retrospective Studies
Universities