Indications for cryopreservation and autotransplantation of ovarian tissue

Cryopreservation and autotransplantation of ovarian tissue as a fertility-preserving treatment are offered to prepubertal girls and women at high risk of developing premature ovarian insufficiency in more than 20 different countries. There is some controversy regarding the main criteria for offering patients this treatment. This article aims to describe the applied indications for cryopreservation and autotransplantation of ovarian tissue.

This review article is based on literature searches in the Embase and Medline databases, restricted to articles published from 2010 onwards.

A total of twelve articles were included, with diagnoses for 1 947 patients in the age group 0-44 years and 820 patients aged less than 18 years. The most frequent indications for cryopreservation of ovarian tissue were breast cancer (694 of 1 947, 36 %) and lymphoma (416 of 1 947, 21 %). Malignant diseases accounted for 86 % of indications. In patients aged less than 18 years, malignant neurological diseases (166 of 820, 20 %), leukaemia (156 of 820, 19 %), sarcomas (125 of 820, 15 %) and benign haematological disorders (124 of 820, 15 %) were the most common indications. In patients aged less than 18 years, 26 % of the indications were benign disorders. The most frequent indications for autotransplantation of ovarian tissue were lymphoma (74 of 196, 38 %) and breast cancer (53 of 196, 27 %).

The frequency of the indications is consistent with the prevalence of the diseases, but further experience is necessary to improve the guidelines for the treatment. The risk of autotransplantation of malignant cells and radiation injury should be taken into account when assessing which patients should be offered treatment.