Introduction
Methods
Search strategy, data extraction, and eligibility criteria
Study selection
Study design | Participants underwent ovarian tissue transplantation | Intervention | Time of procedure | Follow up (median range) | Outcome(s) | (Author, year) |
---|---|---|---|---|---|---|
Case report | A woman with diagnose of anal cancer | Auto-transplantation/frozen tissue | 30.5 years | 225 days | Ovarian function by follicle growth and FSH, LH and E2 | Dittrich et al. 2008 [15] |
Technical note | A woman with diagnose of Hodgkin disease and relapse | Auto-transplantation/frozen tissue | 33 years | Not reported | Ovarian function, fertility and pregnancy | Dittrich et al. 2012 [16] |
Retrospective analysis | 11 women with hematological malignancy, four with Brest cancer, tree with anal cancer and two with ovarian cancer | Auto-transplantation/frozen tissue | Mean age 34.2 years | Ongoing to date of study | Ovarian function and pregnancy | Dittrich et al. 2015 [17] |
Case report | A woman with diagnose of Hodgkin’s lymphoma | Auto-transplantation/frozen tissue | 32 years | 1 year | Ovarian activity with FSH, E2 and LH, fertility | Muller et al. 2012 [18] |
Case report | A woman with diagnose of primary Sjogren’s syndrome | Auto-transplantation/frozen tissue | 42 years | 244 days | Follicular development | Wølner-Hanssen et al. 2005 [19] |
Case report | A woman with diagnose of invasive ductal breast carcinoma | Auto-transplantation/frozen tissue | 44 years | 7 months | Ovarian function by hormonal assay and follicular development, pregnancy | Burmeister et al. 2013 [20] |
Case report | A woman with diagnose of b-thalassemia | Auto-transplantation/frozen tissue | 29 years | 12 months | Restoration of ovarian function, pregnancy, and live birth | Revelli et al. 2013 [21] |
Case report | A woman with papillary thyroid carcinoma and metastases of neck lymph node | Auto-transplantation/frozen tissue | 26 years | 2 years | Ovarian function by FSH, LH, E2 and AMH and pregnancy | Kiseleva et al. 2015 [22] |
Case report | A woman with diagnose of sickle-cell anemia | Auto-transplantation/frozen tissue | 27 years | 4 years | Ovarian function by hormonal level, follicular development and menstrual cycle, pregnancy and live birth | Demeestere et al. 2015 [10] |
Case report | A woman with diagnose of Ewing’s sarcoma | Auto-transplantation/frozen tissue | 28 years | 5 years | Pregnancy and live birth | Ernst et al. 2010 [23] |
Case report | A woman with Hodgkin lymphoma | Auto-transplantation/frozen tissue | 30.5 years | 5 years | Restoration of ovarian function, fertility and pregnancy outcome | Oktay et al. 2011 [24] |
Prospective cohort | A woman with thalassemia | Auto-transplantation/frozen tissue | 29 years | 6.5 years | Gonadal function by FSH, AMH and E2 levels | Biasin et al. 2015 [25] |
Prospective cohort | Four women aged 46–49 year with abdominal hysterectomy and bilateral salpingo oophorectomy for uterine leiomyomas | Auto-transplantation/fresh and frozen tissue | 46–49 years | 1 year | Ovarian function by serum E2 and FSH and follicular growth | Callejo et al. 2001 [26] |
Case report | Three patient of 20, 15 and 12-year old women with diagnose of β-thalassemia major, homozygous sickle cell anemia and AML, respectively underwent chemotherapy and TBI before BMT | Allo-transplantation/fresh tissue | Respectively 35, 32, 32 | 1 year | Ovarian function by hormonal level and follicular development | Donnez et al. 2010 [27] |
Prospective cohort | Three women were included; a 23-years old woman with colorectal cancer dukes b2, 34 years old woman with infiltrating lobular carcinoma and 29 years old woman with Hodgkin’s lymphoma, mixed-cellularity sub-type | Auto-transplantation/frozen tissue | 31, 41 and 39 years | 91 Weeks | Ovarian function by hormonal assessment, ultrasound examination and follicular development | Fabbri et al. 2014 [28] |
Prospective cohort | 10 women with Hodgkin’s lymphoma, sickle cell anemia, Hodgkin’s lymphoma, non-Hodgkin lymphoma, Wegener’s granulomatosis, cerebral tumor, tubo-ovarian abscess, endometriosis, major-thalassemia, AML, sickle cell anemia | Auto and allo-transplantation/fresh and frozen tissue | 24–35 years | 2.5 years | Ovarian function analyzed by systemic levels of FSH, LH, inhibin B, E2, and AMH | Janse et al. 2011 [29] |
Retrospective cohort | 41 women with breast cancer, Mb. Hodgkin, non-Hodgkin, cervical cancer, aplastic anaemia, Ewing sarcoma, paroxysmal nocturnal, Haemoglobinuria sarcoma, Haemolytic uraemic syndrome, ovarian cancer, colon cancer, anal cancer and others | Auto-transplantation/frozen tissue | Mean age: 32.9 years | 10 years | Ovarian function and fertility outcome | Jensen et al. 2015 [30] |
Prospective cohort | Five women presented with cervical cancer (3), breast cancer (1), and Hodgkin’s lymphoma (1) | Auto-transplantation/frozen tissue | Mean age 31 | 7 years | Ovarian function by (FSH, LH, estradiol, progesterone, and testosterone, follicular growth by ultrasound | Kim 2012 [31] |
Retrospective cohort | A woman at the age of 28 with B cell non-Hodgkin’s lymphoma | Auto-transplantation/frozen tissue | One 31-year-old patient | 30 months | Ovarian activity by hormonal assay and follicular growth | Meirow et al. 2007 [32] |
Case report | A woman with mature cystic teratoma and underwent right salpingo-oophorectomy | Auto-transplantation/frozen tissue | 34 years old | 4 years ongoing | Ovarian function by hormonal level and Doppler ultrasound | Fabbri et al. 2018 [33] |
Prospective cohort | 20 cancer survivors’ women with CML, Hodgkin’s, Breast cancer, non-Hodgkin’s lymphoma, Ewing’s sarcoma and AML developed into POF | Auto-transplantation/frozen tissue | 22–45 years | 7 to 141 months | Endocrine profile, IVF, pregnancies, live births | Meirow et al. 2016 [34] |
Prospective cohort | 10 pairs of identical twin sisters out of which one sister of each pair diagnosed with POF received ovarian transplants from other normal sister also another woman whom received her own cryopreserved ovarian tissue at the time of transplantation | Auto and Allo-transplantation/fresh and frozen tissue | 24–40 years | 5 years | Menstrual cycle, hormone levels, pregnancy, live birth, duration of transplant function, and ovarian tissue evaluation | Silber et al. 2010 [35] |
Prospective cohort | 17 infertile women with POI | Auto-transplantation/frozen tissue | ND | Not reported | Follicle growth, serum estrogen level and IVF-embryo transfer | Suzuki et al. 2015 [36] |
Retrospective cohort | Two patients with T cell lymphoma and Hodgkin lymphoma | Auto-transplantation/frozen tissue | 24 and 22 years | 40 months | Ovarian function by FSH and AMH and pregnancy | Tanbo et al. 2015 [37] |
Retrospective cohort | 38 women with hematologic neoplasia (17); with breast carcinoma (10); borderline ovarian cancer and tumor (4), anal cancer (3); premature ovarian failure (2); ovarian cancer (1) and cervical cancer (1) | Auto-transplantation/frozen tissue | 27–44 years | 8 years | Ovarian function confirmed by hormonal analysis, onset of menstrual cycle or elevation of systemic levels of estradiol | Beckmann et al. 2017 [38] |
Case report | One 24 years old patient with diagnose of Hodgkin’s disease stage iv | Auto-transplantation/frozen tissue | 29 years | 267 days | FSH, LH, Follicle count and pregnancy | Demeestere et al. 2006 [39] |
Retrospective cohort | Eight women diagnosed with cancer followed by POF underwent ovarian tissue transplantation for fertility | Auto-transplantation/frozen tissue | 22–39 years | 7 years | Ovarian function and fertility | Imbert et al. 2014 [40] |
Case report | A woman at the age of 18 with acute severe pelvic pain | Auto-transplantation/frozen tissue | 28 years | 8 months | Serum estradiol and FSH, follicular development and pregnancy outcome | Povoa et al. 2016 [41] |
Prospective cohort | 22 patients include 11 POF and 11 cancer patients with Hodgkins, brain cancer, MS, Blood Disorder, Synovial sarcoma and breast cancer | Auto and allo-transplantation/fresh and frozen tissue | ND | In 19 with over 1-year follow-up and in other 240 days | Ovarian function by FSH, LH, estradiol, AMH, and menstrual cycle | Silber et al. 2015 [11] |
Outcomes measures
Results
Clinical characteristics of the selected studies
Total number of patients in study | Second transplantation | Third transplantation | Transplantation site | Number of patient with therapeutic outcome | Onset of ovarian function | Duration of Ovarian function | FSH below 20 (IU/l) | E2 above 100 (pg/ml) | Follicular growth | (Author, year) |
---|---|---|---|---|---|---|---|---|---|---|
1 | 1 | 0 | Right pelvic side wall in peritoneal pocket | 1 | 2.5 months | Not reported | 1 | 1 | 1 | Dittrich et al. 2008 [15] |
1 | 0 | 0 | Pouch of peritoneum in the Board ligament | 1 | 3 months | Not reported | 1 | 1 | 1 | Dittrich et al. 2012 [16] |
20 | 0 | 0 | Peritoneal pocket, below the fallopian tube, Pelvic wall, Ovary | 19 | 4 months | average 1.7 years and Ongoing in 13 patient to date of study | ND | 19 | ND | Dittrich et al. 2015 [17] |
1 | 0 | 0 | Ovarian fossa of the right pelvic wall | 1 | 3 months | Not reported | 1 | 1 | 1 | Muller et al. 2012 [18] |
1 | 0 | 0 | Right forearm | 1 | Not reported | 7 months | ND | 1 | 1 | Wølner-Hanssen et al. 2005 [19] |
1 | 0 | 0 | Ovary | 1 | 4 months | 5 months ongoing | 1 | ND | 1 | Burmeister et al. 2013 [20] |
1 | 0 | 0 | Ovary | 1 | 3 months | 12 months | 1 | ND | 1 | Revelli et al. 2013 [21] |
1 | 0 | 0 | Ovary | 1 | 6 months | 2 years ongoing | ND | ND | 1 | Kiseleva et al. 2015 [22] |
1 | 0 | 0 | Residual left ovary, right peritoneal bursa and trocar incision | 1 | 4 months | 4 years | 1 | 1 | 1 | Demeestere et al. 2015 [10] |
1 | 0 | 0 | Ovary | 1 | Not reported | 4 years ongoing | ND | ND | 1 | Ernst et al. 2010 [23] |
1 | 0 | 0 | Lower abdominal wall | 1 | 2 months | 5 years | 1 | ND | 1 | Oktay et al. 2011 [24] |
47 | 0 | 0 | Orthotopic site | 1 | 3 months | Not reported | ND | ND | ND | Biasin et al. 2015 [25] |
14 | 0 | 0 | Arm (SC), rectus abdominis muscle | 3 | 2–4 months | Not reported | 3 | 3 | 3 | Callejo et al. 2001 [26] |
3 | 0 | 0 | Ovarian cortex | 3 | 3.5–7 months | 1 years | 3 | 3 | 3 | Donnez et al. 2010 [27] |
3 | 0 | 0 | Subcutaneous pockets | 3 | 2–4 months | 91, 61 and 76 weeks ongoing | 3 | 3 | 3 | Fabbri et al. 2014 [28] |
10 | 2 | 0 | Peritoneal incision close to the ovary or on decorticated ovaries | 9 | 3.5–7 months | 9–86 months 17–28 months | 6 | 5 | ND | Janse et al. 2011 [29] |
41 | 11 | 1 | Remaining ovary and into a peritoneal pocket | 40 | Not reported | Not reported | 40 | ND | ND | Jensen et al. 2015 [30] |
5 | 4 | 0 | Heterotopic site such as rectus muscle and sheath | 5 | 2–4 months | 9–84 months | 1 | 1 | 1 | Kim et al. 2012 [31] |
56 | 0 | 0 | Ovary | 1 | Not reported | 30 months | ND | ND | 1 | Meirow et al. 2007 [32] |
1 | 1 | 0 | Peritoneal pocket, left ovary | ND | Not reported | Not reported | ND | ND | 1 | Fabbri et al. 2018 [33] |
20 | 0 | 0 | Subcortical tunnels and peritoneum in the ovarian ligaments | 19 | Not reported | Not reported | 12 | 11 | ND | Meirow et al. 2016 [34] |
25 | 0 | 0 | Denuded medulla | 22 | 4.5 months | All more than 2 years, ½ 6 years, 2 for 8 years | 22 | ND | ND | Silber et al. 2010 [35] |
47 | 0 | 0 | Beneath the serosa of fallopian tubes | ND | Not reported | Not reported | ND | ND | 9 | Suzuki et al. 2015 [36] |
164 | 0 | 0 | Remaining ovary | 2 | Not reported | 40 months | ND | ND | ND | Tanbo et al. 2015 [37] |
399 | 5 | 1 | Peritoneal pocket | 19 | 1 years | Not reported | ND | ND | ND | Beckmann et al. 2017 [38] |
1 | 0 | 0 | Three fragments were placed into the incision in the ovary and nine into the peritoneal pocket | 1 | 3 months | Not reported | 1 | 1 | 1 | Demeestere et al. 2006 [39] |
225 | 1 | 0 | Peritoneal and ovarian sites and orthotopic site. Other peritoneal sites including ovarian bursa and subcutaneous abdominal trocar incision | 4 | 2–5 months | 1–5 years 3 cases ongoing | 4 | N | N | Imbert et al. 2014 [40] |
1 | 0 | 0 | Ovarian fossa and broad ligament | 1 | Not reported | Not reported | 1 | 1 | 1 | Povoa et al. 2016 [41] |
22 | 2 | 2 | Peritoneum of the denuded fallopian tube isthmus | 11 | 60–130 days | 3–4 years | 11 | ND | ND | Silber et al. 2015 [11] |
Primary outcomes
Secondary outcomes
Total number patients | Type of tissue (cryopreservation/fresh) | Pregnancy | Spontaneous pregnancy | IVF pregnancy | Live birth | Abortion | (Author, year) |
---|---|---|---|---|---|---|---|
1 | Cryo | – | – | – | – | – | Dittrich et al. 2008 [15] |
1 | Cryo | 1 | 1 | – | 1 | – | Dittrich et al. 2012 [16] |
20 | Cryo | 7 | 6 | 1 | 4 | 1 | Dittrich et al. 2015 [17] |
1 | Cryo | 1 | 1 | – | 1 | – | Müller et al. 2012 [18] |
1 | Cryo | – | – | – | – | – | Wølner-Hanssen et al. 2005 [19] |
1 | Cryo | 1 | 1 | 1 | – | – | Burmeister et al. 2013 [20] |
1 | Cryo | 1 | 1 | – | 1 | – | Revelli et al. 2013 [21] |
1 | Cryo | 1 | – | 1 | – | – | Kiseleva et al. 2015 [22] |
1 | Cryo | 1 | 1 | – | 1 | – | Demeestere et al. 2015 [10] |
1 | Cryo | 2 | 1 | 1 | 2 | – | Ernst et al. 2010 [23] |
1 | Cryo | 4 | 1 | – | 3 | 1 | Oktay et al. 2011 [24] |
47 | Cryo | 1 | 1 | – | 1 | – | Biasin et al. 2015 [25] |
14 | 1 cryo, 3 fresh | – | – | – | – | – | Callejo et al. 2001 [26] |
3 | Fresh | – | – | – | – | – | Donnez et al. 2010 [27] |
3 | Cryo | – | – | – | – | – | Fabbri et al. 2014 [28] |
10 | 7 cryo, 3 fresh | 2 | 2 | – | – | – | Janse et al. 2011 [29] |
41 | Cryo | 28 | 13 | 15 | 13 | 3 | Jensen et al. 2015 [30] |
5 | Cryo | – | – | – | – | – | Kim et al. 2012 [31] |
56 | Cryo | 1 | – | 1 | 1 | – | Meirow et al. 2007 [32] |
1 | Cryo | – | – | – | – | – | Fabbri et al. 2018 [33] |
20 | Cryo | 16 | 7 | 9 | 10 | 3 | Meirow et al. 2016 [34] |
25 | 11 cryo, 11 fresh | 21 | 19 | 2 | 17 | 7 | Silber et al. 2010 [35] |
47 | Cryo | 3 | – | 3 | 2 | 1 | Suzuki et al. 2015 [36] |
164 | Cryo | 2 | 1 | 1 | 2 | – | Tanbo et al. 2015 [37] |
399 | Cryo | 10 | 10 | – | 9 | – | Beckmann et al. 2017 [38] |
1 | Cryo | 1 | 1 | – | – | 1 | Demeestere et al. 2006 [39] |
225 | Cryo | 5 | 5 | – | 2 | 1 | Imbert et al. 2014 [40] |
1 | Cryo | – | – | – | – | – | Povoa et al. 2016 [41] |
22 | 11 cryo, 11 fresh | 13 | 13 | – | 9 | 4 | Silber et al. 2015 [11] |