Transplanted ovarian tissue in a sterile woman
When is this procedure indicated?
Ovarian tissue may be transplanted at its site of origin or outside the pelvis (e.g., at the forearm or abdominal wall). Like harvesting, reimplantation can also be performed laparoscopically. Ovarian cortical fragments can be placed on the ovary or on a specially created peritoneal pocket in the pelvis and held in place without the use of sutures by fibrin glue. This technique guarantees the best results in terms of reproduction. The conception rate is around 30-40%. Full-term pregnancies from both spontaneous conception and assisted fertilization are reported. On the other hand, the tissue transplanted outside the pelvis is mainly aimed at restoring hormone production and, therefore, the treatment of menopausal symptoms or the induction of puberty in girls.
How is it performed?
The team performs the operation laparoscopically, creating a "pocket" at the removed ovary in which they insert fragments of healthy ovarian tissue previously cryopreserved in liquid nitrogen at -196°. Once the tissue has resumed its normal activity (it will take 3-4 months), on the one hand, the ovarian hormonal activity will restart, with the reappearance of the menstrual cycle and benefits throughout the body (bone metabolism, thyroid function, cardiovascular wellbeing), and, on the other hand, new eggs will be produced that can be fertilized in vitro.
Recovery from surgery is quick, with discharge on the first or second day after surgery, and relative rest is generally recommended for two weeks after discharge.
Short-term complications of surgery occur in a very low percentage of cases, and are predominantly hemorrhagic and infectious.
There are no known specific long-term complications of the surgery. In the case of a procedure performed for fertility preservation in a patient with a malignant tumor, the risk of developing a recurrence of the initial tumor following cryopreserved ovarian tissue transplantation is theoretically possible especially in the case of hematologic neoplasms. However, to date, tumor recurrences caused by the return of cryopreserved ovarian tissue have never been reported.