Highlights
- •Ovarian tissue cryopreservation and transplantation (OTCT) is increasingly being used in young cancer patients for fertility restoration and the prevention of premature ovarian insufficiency.
- •Ovarian tissue cryopreservation and transplantation has recently been advocated as a method to delay menopause.
- •Ovarian tissue cryopreservation and transplantation to delay menopause may need to be repeated several times to achieve long-term restoration of ovarian function.
- •It is not clear whether ovarian grafts result in a normal steroid pulsatile secretion, similar to that present during reproductive years.
- •It is not known whether the need to restore ovarian activity appears earlier in women who undergo OTCT to delay menopause.
- •There is no evidence to suggest that OTCT is superior to hormone replacement therapy in terms of both efficacy and safety.
Abstract
Ovarian tissue cryopreservation and transplantation (OTCT) is increasingly being used
in young cancer patients for fertility restoration and prevention of premature ovarian
insufficiency (POI) and has recently been advocated as a method to delay menopause.
This is accomplished by cryopreserving ovarian tissue that is excised laparoscopically
in thin pieces at a young age. Cryopreserved tissue will be transplanted at menopause,
when ovarian function is no longer present. Transplantation may need to be repeated
several times to achieve long-term restoration of ovarian function. However, it is
unknown whether ovarian grafts result in a normal steroid pulsatile secretion, similar
to that present during reproductive years. In addition, it is not known whether the
need to restore ovarian activity appears earlier in women who undergo OTCT to delay
menopause, although indirect data suggest that this is likely to be true. Until today,
no cohort or comparative studies evaluating OTCT as a potential alternative to hormone
replacement therapy (HRT) have been published and, thus, there is no evidence to suggest
that OTCT is superior to HRT in terms of both efficacy and safety. Given the availability
of alternative, established treatments for managing menopausal symptoms, as well as
the multiple unanswered questions regarding the method, it is imperative that, before
OTCT is regarded as a mainstream technique for management of menopausal symptoms,
further evaluation and clinical investigation are undertaken.
Keywords
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Article info
Publication history
Published online: July 22, 2020
Accepted:
July 21,
2020
Received in revised form:
July 15,
2020
Received:
May 2,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
