Laparoscopic ovariectomy for whole human ovary cryopreservation: technical aspects

OBJECTIVE: To describe the technique of laparoscopic ovariectomy with a view to cryopreservation of a whole ovary with its vascular pedicle.

DESIGN: Descriptive study.

SETTING: Gynecology research unit in a department of gynecology in a university hospital.

PATIENT(S): Women with indications for chemotherapy or radiotherapy who are at high risk of premature ovarian failure.

INTERVENTION(S): Laparoscopic ovariectomy for whole ovary cryopreservation in nine patients.

MAIN OUTCOME MEASURE(S): Feasibility of laparoscopic ovariectomy for whole ovary cryopreservation and later autotransplantation without delaying chemotherapy.

RESULT(S): The whole ovary was successfully removed by laparoscopy and cryopreserved by arterial catheterization in all nine patients.

CONCLUSION(S): Ovariectomy with a view to whole ovary cryopreservation for future transplantation may be performed by laparoscopy. Great care must be taken to remove the ovary, together with a large part (> or =5 cm) of the infundibulopelvic ligament, allowing dissection of the ovarian vessels, perfusion with a cryoprotective medium, and cryopreservation for subsequent autografting of the whole ovary. The period of ischemia between ligation of the ovarian pedicle and ovarian cryopreservation must be as short as possible.