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OVARIAN CRYOPRESERVATION

Background

Cryopreservation of ovarian tissue is a technique to bank immature oocytes (eggs) in situations where the woman may lose all her eggs from a medical treatment, disease process, or even the natural loss from aging. Chemotherapy and radiation can damage or destroy oocytes and follicles, which can cause either immediate menopause or premature menopause years after treatment. Many patients who return to menstruation after the completion of cancer treatment believe their reproductive capacity has not been affected. This may not be the case and consultation with a fertility doctor before starting cancer treatment is important. Chemotherapy and radiotherapy can affect the ovaries but radiation can also damage the uterus and increase the risk of miscarriage or low birth-weight. Potential uses for this experimental technique to freeze ovarian tissue includes restoring fertility and normal ovarian hormone production. You should be aware that the procedure to take ovarian tissue and potentially put it back into your body is considered a surgical intervention and called a laparoscopy.

Our Reproductive Tissue Bank can cryopreserve small portions of the human ovary. Thin slices of ovarian tissue can be recovered laparoscopically and successfully frozen in liquid nitrogen. Ovarian tissue freezing involves the removal, sectioning and freezing of pieces of an ovary. The ovarian strips can be transplanted later to restore hormonal function and for use with IVF. Post-treatment, patients should undergo fertility testing to assess their reproductive status. The immature eggs contained in the ovary survive the freezing process better than mature, ovulated eggs.


Cancer Patients

This technique has important implications for women undergoing chemotherapy or radiotherapy for cancer treatment. Such treatment can irreversibly damage the ovaries and destroy the eggs, rendering a woman sterile. Not all women will become infertile. The effects depend upon the agent used and the age of the woman. Women can elect to have some tissue stored so that if they do become infertile, some tissue will be protected from the effects of the drugs.

Research in in vitro maturation of immature oocytes from frozen ovarian tissue is showing promising results and this is a clear option for the future. Ovarian tissue has been successfully re-implanted in a small number of healthy women volunteers in the United States, where it has functioned normally for a few weeks. Animal studies have been more successful and the ovaries have survived long enough to allow natural conception in sheep. In mice, the ovarian tissue has been cultured in the laboratory and mature, genetically competent egg cells have been recovered, fertilized, and re-implanted, leading to live births.


Ovarian Cryopreservation Service at
The Cleveland Clinic Foundation

You may discuss the details of this procedure with a Reproductive Endocrinologist by calling the
OB-GYN and Women's Health Institute at
(216) 444-6601 or 1-800-CCF-CARE, extension 46601
OR
the Reproductive Tissue Bank at
1-866-9BANKING (866-922-6546)(Toll Free) or (216) 444-8182.


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Last Update : April 15, 2009
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Center for Reproductive Medicine
The Cleveland Clinic
9500 Euclid Avenue, Desk A19
Cleveland OH 44195
U.S.A.
CRM@ccf.org