Heterotopic Ovarian Tissue Transplantation
(2016) Gonadal Tissue Cryopreservation in Fertility Preservation — ISBN: [9784431559610], p. 105-123, published
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- Restoration of ovarian function has been consistently observed after transplantation of ovarian tissue to heterotopic sites, and recent reports now confirm that ovarian function following heterotopic transplantation can last more than 7 years, depending on the initial ovarian reserve. The possibility of long-term restoration of ovarian function, combined with the advantage of a less invasive and more cost-efficient procedure (especially when considering repeated transplantations), makes heterotopic transplantation the technique of choice when the main goal of grafting is restoration of endocrine function. Although follicle development, oocyte retrieval and fertilization, and embryo development have been demonstrated after heterotopic transplantation of frozen-thawed ovarian tissue to various heterotopic sites, oocyte quality, and hence embryo quality, appear to be compromised. This is probably attributable to the nonoptimal environment for follicular development. Teams who have simultaneously grafted ovarian tissue to orthotopic as well as heterotopic sites report superior results with orthotopic sites. Therefore, when fertility restoration is the goal, there is no doubt that orthotopic sites in the pelvic cavity (ovarian medulla or pelvic peritoneum), although more invasive, are much more effective, as evidenced by the number of live births. Moreover, grafting of ovarian tissue to a subperitoneal pocket in the abdominal wall could potentially be an option in case of severe pelvic adhesions that preclude pelvic surgery, or in addition to grafting to orthotopic sites, and should be investigated further
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Soares, M., Dolmans, M.-M., & Donnez, J. (2016). Heterotopic Ovarian Tissue Transplantation. In Nao Suzuki, Jacques Donnez (eds.) (ed.), Gonadal Tissue Cryopreservation in Fertility Preservation (p. p. 105-123). Springer. https://doi.org/10.1007/978-4-431-55963-4_7