[Ovarian cryopreservation and autotransplantation as a new method for fertility preservation].

Abstract

Ovarian cryopreservation and autotransplantation offer a promising opportunity for preserving fertility in patients undergoing gonadotoxic treatment of malignant diseases. The aim of the procedure is to restore ovarian function following treatment and prevent premature ovarian failure. The aim of this case study is to present the method of ovarian cryopreservation and autotransplantation and to review the current scientific literature on the subject. A 25-year-old female patient diagnosed with acute lymphoblastic leukemia underwent ovarian tissue cryopreservation prior to myeloablative treatment. Following her remission, the ovarian tissue was orthotopically autotransplanted, after which the patient was monitored through weekly hormone level assessments (FSH, LH, estradiol, progesterone) and transvaginal ultrasounds. Gonadotropin and ovarian hormone levels showed no significant changes between postoperative days 7 and 63. By day 145, ovarian endocrine function was restored as indicated by decreased gonadotropin levels and normalized estradiol levels. In the literature, the 5-year survival rate of ovarian grafts during long-term follow-up was reported at 55%, with restoration of reproductive function and spontaneous pregnancies occurring in some cases. The method has proven effective in restoring both endocrine and reproductive functions, with the highest likelihood of achieving pregnancy shortly after the procedure. Previous studies have reported live birth rates as high as 41% following ovarian cryopreservation and autotransplantation. Ovarian cryopreservation and autotransplantation provide a valuable opportunity for preserving fertility in patients undergoing gonadotoxic treatments. Although our experience is limited to a single case, the results are encouraging. Further research is needed to optimize the procedure and expand its clinical application. Orv Hetil. 2025; 166(5): 195–200.