Ovarian tissue cryopreservation during surgical treatment of patients with gynecological malignancies in Slovenian population

Introduction / Background As a common side effect of cytotoxic cancer treatments, the probability of young female cancer survivors to conceive after chemotherapy and radiotherapy is reduced. One of the promising and effective methods for fertility preservation of women undergoing these treatments is the autotransplantation of frozen-thawed ovarian tissue. It is still an experimental method, but it resulted in at least 42 healthy babies worldwide without any increased risk for miscarriage or congenital anomalies. Methodology We performed a retrospective, cohort study in 24 patients with different advanced gynecological malignancies (predominating ovarian and cervical cancer) treated at the Department of Obstetrics and Gynecology, University Medical Centre Ljubljana between 2001 and 2015. During the same surgery, their ovarian tissue was removed and cryopreserved. We assessed the post-operative outcome in these patients including their natural fertility. Results In this study 12 patients with ovarian, 5 with cervical and 3 with uterine cancer, and the rest (secondary cancer) were included. The mean female age at the time of surgery was 29,3 years. In spite of advanced cancer, 18 (75 %) patients survived the cancer, are still alive. At the time of surgery only one patient had a baby after natural conception, while other patients were nullipara; most of them still don't have a baby. The mean time of ovarian tissue cryostorage is 9,5 years (from 3,4 to 17,9 years). In patients with ovarian cancer the cryopreserved ovarian tissue is the only source of follicles/oocytes; among patients with cervical and uterine cancer, in 9 (50 %) patients the hysterectomy was done, while in the rest the uterus is intact. Conclusion Cryopreservation of ovarian tissue retrieved during the cancer surgery is also reasonable in patients with advanced gynecological malignancies but needs to involve the efficient follow-up of these patients and an active communication with gynecologists.