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Laparoscopic ovariectomy for whole human ovary cryopreservation: technical aspects
Pascale Jadoul1, Jacques Donnez, Marie-Madeleine Dolmans
1Department of Gynecology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Objective:
To describe the technique of laparoscopic ovariectomy with a view to cryopreservation of a whole ovary with its vascular pedicle.
Design:
Descriptive study.
Setting:
Gynecology research unit in a department of gynecology in a university hospital.
Patient(S):
Women with indications for chemotherapy or radiotherapy who are at high risk of premature ovarian failure.
Intervention(S):
Laparoscopic ovariectomy for whole ovary cryopreservation in nine patients.
Main Outcome Measure(S):
Feasibility of laparoscopic ovariectomy for whole ovary cryopreservation and later autotransplantation without delaying chemotherapy.
Result(S):
The whole ovary was successfully removed by laparoscopy and cryopreserved by arterial catheterization in all nine patients.
Conclusion(S):
Ovariectomy with a view to whole ovary cryopreservation for future transplantation may be performed by laparoscopy. Great care must be taken to remove the ovary, together with a large part (> or =5 cm) of the infundibulopelvic ligament, allowing dissection of the ovarian vessels, perfusion with a cryoprotective medium, and cryopreservation for subsequent autografting of the whole ovary. The period of ischemia between ligation of the ovarian pedicle and ovarian cryopreservation must be as short as possible.
