Risk of transplanting malignant cells in cryopreserved ovarian tissue

Improvements in cancer treatments have increased the chances of survival of young cancer patients, but have given rise to other issues, like premature ovarian insufficiency and infertility. Preservation and subsequent restoration of ovarian function in these patients is now possible thanks to ovarian tissue cryopreservation and transplantation. However, safety concerns about the possible presence of cancerous cells in the tissue to be cryopreserved must be addressed. Indeed, reimplantation of malignant cell-contaminated ovarian tissue could potentially lead to recurrence of the primary disease. This review of the existing literature aims to evaluate the risk of reintroducing malignant cells in pathologies that represent the main indications for ovarian tissue cryopreservation. Experimental studies applying molecular analyses as well as xenografting investigation have proved that hematologic and ovarian malignancies are those at greatest risk of ovarian involvement, and hence recurrence upon reimplantation of frozen-thawed ovarian tissue. Preimplantation analysis using highly sensitive techniques and disease-specific markers is therefore vital in these patients to detect minimal disseminate disease.