Ovarian tissue cryopreservation and transplantation to delay menopause: facts and fiction. (December 2020)

• Record Type: Journal Article
• Authors: Kolibianaki, E.E.; Goulis, D.G.; Kolibianakis, E.M.
• Is Part Of: Maturitas. Volume 142(2020)
• Page Start: 64
• Page End: 67
• Publication Date: 2020-12
• Subjects: OTCT -- ovarian tissue cryopreservation -- transplantation -- Menopause; Climacteric -- Periodicals; Menopause -- Periodicals; Climacteric -- Periodicals; Geriatrics -- Periodicals; Menopause -- Periodicals; Middle Aged -- Periodicals; Climatère -- Périodiques; Ménopause -- Périodiques; Climacterium; Climacteric; Menopause; Electronic journals; Periodicals; 612.66
• DOI: 10.1016/j.maturitas.2020.07.007
• Languages: English
• ISSNs: 0378-5122

Abstract

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.