Heterotopic autotransplantation of cryobanked human ovarian tissue as a strategy to restore ovarian function.

Objective: To investigate ovarian function after heterotopic autotransplantation of human ovarian tissue banked at -196 degrees C.
Design: A clinical case study.
Setting: University medical center.
Patient(s): A 37-year-old woman with cervical cancer (stage Ib).
Intervention(s): Frozen-thawed human ovarian tissue was transplanted to two different heterotopic sites.
Main Outcome Measure(s): Ovarian function of the grafts was monitored sequentially by blood sampling for the hormonal profiles and by ultrasound.
Result(s): The hormonal profile remained at the postmenopausal level until 10 weeks after transplantation. By 14 weeks, the return of ovarian function was evidenced by the elevation of the serum E(2) level (57.5 pg/mL). While monitoring hormonal profiles every 2 days for 5 weeks, we observed the LH surge (69.8 IU/L) followed by the elevation of the P(4)concentration (9.6 ng/mL), suggesting presumptive ovulation. The ultrasound revealed a dominant follicle on the rectus muscle in the abdominal site. However, there was no sign of follicle development in the breast site. Ovarian function ceased around 28 weeks after transplantation.
Conclusion(s): Heterotopic autotransplantation of cryobanked human ovarian tissue can be a practical strategy for restoration of ovarian function after cancer treatment. As a site for transplantation, a space between the rectus sheath and the rectus muscle appeared to be effective.