Ovarian tissue cryopreservation for non-malignant indications

Ovarian tissue cryopreservation (OTC) is not restricted to patients suffering from malignancies. Benign haematopoietic diseases such as autoimmune diseases and others have been mentioned to be feasible indications. The aim of our study was to demonstrate that surgery for OTC is a safe procedure for fertility preservation in patients with non-malignant diseases.

In a retrospective cohort study intra- and postoperative courses were evaluated. Histological examination of one random ovarian cortical slice was performed to determine the presence of primordial follicles. Immediately after the excision, microbiological culture techniques from swabs were taken from all slices.

Seven of 85 patients (8.2%) have undergone surgery for OTC for non-malignant indications. All patients had an uncomplicated intraoperative course. A median number of 12 cortical stripes were excised and cryopreserved (range 7-17). Only for one patient an adverse event was found which was not related to laparoscopy for OTC. All patients having undergone routine laparoscopy for OTC only could be released from hospital on the first postoperative day. Selective microbiological tests showed negative results in all cases. Histological examinations revealed intact ovarian tissue with primordial follicles in 6/7 patients.

Whether surgery for OTC in patients with non-malignant indications is feasible from an ethical point of view remains open. However, laparoscopy for ovarian tissue harvesting is a safe procedure for patients undergoing cytotoxic treatment for benign diseases.