Laparoscopic ovariectomy for whole human ovary cryopreservation: technical aspects

Jadoul, Pascale [UCL] Donnez, Jacques [UCL] Dolmans, Marie-Madeleine [UCL] Squifflet, Jean [UCL] Lengelé, Benoît [UCL] Martinez-Madrid, Belen [UCL]

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.