The significance of autofogous ovarian tissue transplantation during radical surgery of recurrent endometriosis

Objective To evaluate the efficacy of autologous ovarian tissue transplantation at the time of radical surgery in patients with recurrent endometriosis after conservative surgical procedures.Methods Seventeen cases of recurrent endometro-sis, aged 31 - 40 years after one or two times of conservative surgeries for endometriosis underwent radical surgery between February 1997 and March 2000.Their ovarian tissue fragments were transplanted to greater omentum during the time of radical surgery. All women received post- operative estrogen replacement therapy (ERT) for 3 months. One month after the stop of ERT, sera follicle-stimulation hormone (FSH), luteinizing hormone (LH) and estradiol (E2) levels were measured once a month respectively until ovarian function recovered completely. After E2 was increased, basal body temperature was measured for three months and vaginal hormone cytology was examined weekly for maturation index (MI) and four times recorded as a cycle.Results All women have no recurrence of endometriosis. There were 8 cases who had increasing of ? four months post operatively and 7 cases six months. The other 2 cases with serum E2 keeping at low value, while FSH and LH showed an increasing trend during 12 months indicated the loss of viability of the transplanted ovarian tissues post-operative. The survival rate of transplanted ovarian tissue was 88.2% . The basal body temperature present biphasic changes and vaginal hormone cytology showed cyclic changes when the function of transplanted ovarian tissue recovered completely. Conclusions Transplantation of ovarian tissue fragments during radical surgery for recurrent endometriosis is a good method to avoid recurrence of endometriosis as well as reconstruct ovarian function.