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Hum. Reprod. Advance Access originally published online on August 11, 2009
Human Reproduction 2009 24(11):2778-2787; doi:10.1093/humrep/dep289
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© The Author 2009. 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

IVF outcome in patients with orthotopically transplanted ovarian tissue

Marie-Madeleine Dolmans, Jacques Donnez1, Alessandra Camboni, Dominique Demylle, Christiani Amorim, Anne Van Langendonckt and Céline Pirard

Department of Gynecology, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Avenue Hippocrate, 10 B-1200, Brussels, Belgium

1 Correspondence address. Catholic University of Louvain, Avenue Hippocrate 10, Brussels, Belgium. E-mail: donnez{at}gyne.ucl.ac.be

BACKGROUND: Chemo- or radiotherapy can induce premature ovarian failure (POF), and ovarian tissue cryopreservation and transplantation may be proposed to restore ovarian function. Our aim was to evaluate the quality of oocytes and embryos derived from frozen-thawed transplanted ovarian tissue.

MATERIALS AND METHODS: Women were 21–28 years old at tissue cryopreservation. Nine women suffering POF following chemotherapy with or without radiotherapy underwent orthotopic ovarian tissue transplantation. After 12 months of spontaneous cycles without pregnancy, oocyte retrieval was performed in four patients during mildly stimulated or spontaneous cycles. ICSI was performed in all cases, with embryo transfer on day 3. Light and electron microscopy was used to study oocytes and embryos.

RESULTS: Signs of ovarian function restoration (estradiol peak, decreased FSH, follicular development) began 16–26 weeks after reimplantation. Twenty-one oocyte retrieval attempts were made. At least one oocyte was collected in 15 cases, giving an empty follicle rate per retrieval of 29% (6/21). Sixteen oocytes were recovered, of which 6 were abnormal or immature (38%) and 10 (62%) were in metaphase II (MII). Three MII oocytes failed to fertilize, two showed abnormal fertilization and five normal MII oocytes successfully fertilized with subsequent normal embryo development (Grade 2), yielding an embryo transfer rate of 24% per retrieval. No pregnancy occurred.

CONCLUSIONS: IVF in women with orthotopically grafted frozen-thawed ovarian tissue involves a higher risk of empty follicles, abnormal or immature oocytes, and low embryo transfer rates.

Key words: IVF/orthotopic autotransplantation/ovarian tissue cryopreservation/fertility preservation/chemotherapy

Submitted on April 3, 2009; resubmitted on July 13, 2009; accepted on July 14, 2009.


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