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Hum. Reprod. Advance Access originally published online on July 17, 2008
Human Reproduction 2008 23(11):2475-2483; doi:10.1093/humrep/den248
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Ovarian function after removal of an entire ovary for cryopreservation of pieces of cortex prior to gonadotoxic treatment: a follow-up study

Mikkel Rosendahl1,2,5, Claus Yding Andersen1, Erik Ernst3, Lars G. Westergaard4, Per Emil Rasmussen4, Anne Loft2 and Anders Nyboe Andersen2

1 Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, Denmark 2 The Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Denmark 3 Reproductive Laboratory, Skejby University Hospital, Aarhus, Denmark 4 The Fertility Clinic, Odense University Hospital, Denmark

5 Correspondence address: E-mail: mikkel.rosendahl{at}rh.regionh.dk

BACKGROUND: Ovarian function was studied in Danish patients who had ovarian tissue cryopreserved, and the patients' experiences with the procedure were investigated.

METHODS: There were 92 women who had an entire ovary removed for cryopreservation 18–75 months earlier. Reasons included: breast cancer (n = 31; 34%), Hodgkin's lymphoma (n = 23; 25%), bone marrow transplantation (BMT) (n = 19; 21%) and others (n = 19; 21%). Patients completed a questionnaire, and transvaginal ultrasonic antral follicle count and serum analysis for follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH) were performed in 73 women.

RESULTS: In total, 11% of the BMT patients had normal ovarian function. Hodgkin's patients who only received ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) (n = 12) and 60% of the breast cancer patients showed little evidence of ovarian damage. Regular menstruation was shown to be a good indicator of ovarian function. The cryopreservation procedure rarely complicated cancer treatment (5%) and 84% felt comforted because they had potentially secured their fertility.

CONCLUSIONS: Cryopreservation of ovarian tissue should be considered in young female patients with Hodgkin's lymphoma receiving more aggressive treatment than ABVD and in patients scheduled for BMT. The recommendation for breast cancer patient should be individualized. The cryopreservation process did not delay cancer treatment.

Key words: fertility preservation/cryopreservation/ovarian reserve/cancer/AMH

Submitted on April 10, 2008; resubmitted on May 26, 2008; accepted on June 3, 2008.


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