EC Gynaecology

Background: Formerly, the life expectancy of women was around the third decade, preserving their ovarian function. With technological development, better socioeconomic and health conditions, they currently live until the ninth decade of life; with a third or more after menopause; with the risk that this entails due to chronic non-communicable diseases associated with hormonal deficiency. It has been suggested that transplantation of cryopreserved ovarian tissue in reproductive life, implanted at menopause, would restore ovarian activity after menopause.

Methodology: To obtain the information, a bibliographic review was carried out in the electronic databases of Google and PubMed-Medline. Articles in English were reviewed between the years 2015 and 2023, with the combination of English terms MeSH: Ovarian tissue cryopreservation and transplantation in menopause.

Results: 59 articles were located, of which 32 were excluded as they were considered not appropriate for the specific topic of the review. 27 articles were selected, including originals, prospective studies and reviews.

Conclusion: Ovarian tissue transplantation could become the anti-aging therapy by restoring long-term ovarian endocrine function. However, more evidence is required to achieve and promote the health of women in menopause.

 Keywords: Hormone Therapy; Menopause; Cancer; Cryopreservation and Ovarian Tissue Transplantation

1. Li HWR., et al. “Clinical Applications of Anti-Mullerian Hormone and its Measurement in Reproductive Medicine and Women’s Health”. Lausanne: Frontiers Media SA (2022).
2. Donnez J and Dolmans MM. “Ovarian cortex transplantation: 60 reported live births brings the success and worldwide expansion of the technique towards routine clinical practice”. The Journal of Assisted Reproduction and Genetics 32 (2015): 1167-1170.
3. Donnez J and Dolmans MM. “The ovary: from conception to death”. Fertility and Sterility 108 (2017): 594-595.
4. Donnez J and Dolmans MM. “Fertility preservation in women”. The New England Journal of Medicine 377 (2017): 1657-1665.
5. Lobo RA. “Hormone-replacement therapy: current thinking”. Nature Reviews Endocrinology 13 (2017): 220-231.
6. Lobo RA. “Reproductive endocrinology: Don't be so quick to stop hormone-replacement therapy”. Nature Reviews Endocrinology 12 (2016): 11-13.
7. Lobo RA., et al. “Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause”. Atherosclerosis 254 (2016): 282-290.
8. Vargas Hernández VM., et al. “Post-Reproductive Health. Opportunity window for the Prevention of Co-Morbidities”. Journal of Womens Health, Issues and Care1 (2021).
9. Kim J., et al. “Oral postmenopausal hormone therapy and genetic risk on venous thromboembolism: Gene-hormone interaction results from a large prospective cohort study”. Menopause (2022).
10. Janse F., et al. “Limited value of ovarian function markers following orthotopic transplantation of ovarian tissue after gonadotoxic treatment”. The Journal of Clinical Endocrinology and Metabolism4 (2011): 1136-1144.
11. Meijun Pan., et al. “Update on hormone therapy for the management of postmenopausal women”. Bio Science Trends1 (2022): 46-57.
12. Cavalcante MB., et al. “Ovarian aging in humans: potential strategies for extending reproductive lifespan”. Gero Science (2023).
13. Andersen CY and Kristensen SG. “Response: transplantation of ovarian tissue to postpone menopause - is it really more advantageous for women's health than menopause hormone therapy?” Reproductive BioMedicine Online 31 (2015): 828.
14. Damásio LC., et al. “Heterotopic ovarian transplantation results in less apoptosis than orthotopic transplantation in a minipig model”. Journal of Ovarian Research 9 (2016): 14.
15. Lee DM., et al. “Subcutaneous ovarian tissue transplantation in nonhuman primates: duration of endocrine function and normalcy of subsequent offspring as demonstrated by reproductive competence, oocyte production, and telomere length”. The Journal of Assisted Reproduction and Genetics 34 (2017): 1427-1434.
16. Manavella DD., et al. “Adipose tissue-derived stem cells in a fibrin implant enhance neovascularization in a peritoneal grafting site: a potential way to improve ovarian tissue transplantation”. Human Reproduction 33 (2017): 270-279.
17. Gullo G., et al. “Ovarian tissue cryopreservation and transplantation in menopause: new perspective of therapy in postmenopausal women and the importance of ethical and legal frameworks”. European Review for Medical and Pharmacological Sciences24 (2022): 9107-9116.
18. EE Kolibianaki., et al. “Ovarian tissue cryopreservation and transplantation to delay menopause: facts and fiction”. Maturitas 142 (2020): 64-67.
19. Oktay KH., et al. “Delaying Reproductive Aging by Ovarian Tissue Cryopreservation and Transplantation: Is it Prime Time?” Trends in Molecular Medicine8 (2021): 753-761.
20. Pacheco F and Oktay K. “Current success and efficiency of autologous ovarian transplantation: a meta-analysis”. Reproductive Sciences 24 (2017): 1111-1120.
21. Kristensen SG and Andersen CY. “Cryopreservation of ovarian tissue: opportunities beyond fertility preservation and a positive view into the future”. Frontiers in Endocrinology 9 (2018): 347.
22. Oktay KH., et al. “Improving autologous ovarian transplantation outcomes with robotic surgery and the utility of a neovascularizing human extracellular matrix (ECM) scaffold”. Human Reproduction1 (2019).
23. Von Wolff M., et al. “Transplantation of ovarian tissue to postpone menopause - is it really more advantageous for women's health than menopause hormone therapy?” Reproductive BioMedicine Online 31 (2015): 827.
24. Patrizio P and Caplan AL. “Forever young? The ethical challenges of using ovarian tissue transplants to treat menopause”. Reproductive BioMedicine Online 31 (2015): 132-133.
25. Vuković P., et al. “Importance of ovarian tissue cryopreservation in fertility preservation and anti-aging treatment”. Gynecological Endocrinology11 (2019): 919-923.
26. Jacques Donnez and Marie-Madeleine Dolmans. “Natural hormone replacement therapy with a functioning ovary after the menopause: dream or reality?” Reproductive BioMedicine Online3 (2018): 359-366.
27. Chen J., et al. “Ovarian tissue bank for fertility preservation and anti-menopause hormone replacement”. Frontiers in Endocrinology 13 (2022): 950297.