Chapter 23
Cryopreservation and Thawing of Human Ovarian Cortex
Tissue Slices
Jana Liebenthron and Markus Montag
Abstract
Cryopreserved ovarian cortex tissue can be used to improve or restore female fertility. It can be used for
cancer patients to restore fertility after chemotherapy treatment or for social reasons for women who want
to postpone their pregnancy wish. In order to preserve ovarian tissue viability in these cases, the tissue needs
to be stored by cryopreservation. In this chapter we describe the entire process chain needed to prepare,
transport, and cryopreserve human ovarian cortex tissues as well as to subsequently thaw and implant it.
Key words Fertility preservation, Ovarian tissue, Overnight transportation, Cryopreservation, Medical freezing, Gonadotoxic therapy, FertiPROTEKT
1 Introduction
Cryopreservation of ovarian tissue for later transplantation in case
of pregnancy and therapy-induced premature ovarian failure is an
established and standardized reproductive technique for postpubertal patients. More than 170 live births have been documented
worldwide [1–11]. It is based on the fact that ovarian tissue transplants can temporarily restore endogenous hormone production
and therefore primary ovarian function [3, 11, 12]. As a positive
side effect, this may even eliminate menopausal symptoms, and—
which is the main criterion—spontaneous pregnancies (i.e., without the aid of further reproductive procedures) can be achieved
from a pool of still existing oocytes in their physiological environment in the transplanted strips [1–11]. Removal of ovarian tissue is
independent of the menstrual cycle, so that a delay in oncological
therapy is not to be expected [13, 14]. The authors of the Edinburgh criteria set themselves an upper age limit of 35 years [15]; in
other international publications, the limit is 40 years [16]. Published success rates of van der Ven et al. [11] from the German
fertility protection network FertiPROTEKT confirm these recommendations: While the pregnancy rates after transplantation of
Willem F. Wolkers and Harrie ¨ tte Oldenhof (eds.), Cryopreservation and Freeze-Drying Protocols, Methods in Molecular Biology,
vol. 2180, https://doi.org/10.1007/978-1-0716-0783-1_23, © Springer Science+Business Media, LLC, part of Springer Nature 2021
485
Cryopreservation and Thawing of Human Ovarian Cortex
Tissue Slices
Jana Liebenthron and Markus Montag
Abstract
Cryopreserved ovarian cortex tissue can be used to improve or restore female fertility. It can be used for
cancer patients to restore fertility after chemotherapy treatment or for social reasons for women who want
to postpone their pregnancy wish. In order to preserve ovarian tissue viability in these cases, the tissue needs
to be stored by cryopreservation. In this chapter we describe the entire process chain needed to prepare,
transport, and cryopreserve human ovarian cortex tissues as well as to subsequently thaw and implant it.
Key words Fertility preservation, Ovarian tissue, Overnight transportation, Cryopreservation, Medical freezing, Gonadotoxic therapy, FertiPROTEKT
1 Introduction
Cryopreservation of ovarian tissue for later transplantation in case
of pregnancy and therapy-induced premature ovarian failure is an
established and standardized reproductive technique for postpubertal patients. More than 170 live births have been documented
worldwide [1–11]. It is based on the fact that ovarian tissue transplants can temporarily restore endogenous hormone production
and therefore primary ovarian function [3, 11, 12]. As a positive
side effect, this may even eliminate menopausal symptoms, and—
which is the main criterion—spontaneous pregnancies (i.e., without the aid of further reproductive procedures) can be achieved
from a pool of still existing oocytes in their physiological environment in the transplanted strips [1–11]. Removal of ovarian tissue is
independent of the menstrual cycle, so that a delay in oncological
therapy is not to be expected [13, 14]. The authors of the Edinburgh criteria set themselves an upper age limit of 35 years [15]; in
other international publications, the limit is 40 years [16]. Published success rates of van der Ven et al. [11] from the German
fertility protection network FertiPROTEKT confirm these recommendations: While the pregnancy rates after transplantation of
Willem F. Wolkers and Harrie ¨ tte Oldenhof (eds.), Cryopreservation and Freeze-Drying Protocols, Methods in Molecular Biology,
vol. 2180, https://doi.org/10.1007/978-1-0716-0783-1_23, © Springer Science+Business Media, LLC, part of Springer Nature 2021
485