Cryopreservation, In Vitro Maturation, and Transplantation of Ovary Tissue

This chapter reviews 24 years of experience with frozen ovarian transplantation and recent experience with in vitro gametogenesis and robust in vitro maturation (IVM) of oocytes from human ovarian tissue. Every woman had a return of ovarian function 5 months after transplant, similar to previous observations. As observed before, anti-Müllerian hormone (AMH) concentration rose as FSH fell 4 months later. The grafts continued to work up to 8 years. Of the 17, 13 (76%) became pregnant with intercourse at least once, resulting in 19 healthy live births, including 6 live births from three women who had had leukemia. Of the harvested germinal vesicle oocytes, 35% developed with simple culture media into mature metaphase II oocytes. First, conclusion: ovary tissue cryopreservation is a robust method for preserving fertility even for women with leukemia, without a need to delay cancer treatment. Second, many mature oocytes can often be obtained from ovary tissue with simple media and no need for ovarian stimulation. Third, ovarian stimulation will only be necessary for removing the oocyte from the ovary, which can also be accomplished by simple dissection at the time of ovary freezing.