Fallbericht: heterotope Retransplantation von kryokonserviertem Ovarialgewebe nach Adenokarzinom der Cervix uteri

Lipovac, Markus; Herzog, Julia; Imhof, Martin

INTRODUCTION: Retransplantation of cryopreserved ovarian tissue has become an established method of restoring autologous hormone production and fertility after radiotherapy and/or chemotherapy for underlying oncological disease in women of reproductive age and has so far led to more than 170 births worldwide. CASE PRESENTATION AND COURSE: In 2013, the 31-year-old patient developed adenocarcinoma of the uterine cervix, pT1b1V0L0. In January 2014, an extended hysterectomy with lymph node dissection and bilateral adnexectomy were performed. At the patient’s request, ovarian tissue was cryopreserved 2 days previously. In November 2019, the retransplantation of two ovarian tissue pieces along the brachial fascia of the left forearm was performed, with no recurrence for 5 years under ongoing hormone replacement therapy (HRT). At 1 month following retransplantation, the patient stopped taking HRT, and 3 months later proper function of the retransplanted tissue could be demonstrated by checking gonadotropins and E2 levels. There was a clear swelling in the area of the retransplantation site, and three vital follicles could be visualized during an ultrasound examination in May 2020. CONCLUSION: This is the first successful retransplantation of cryopreserved ovarian tissue to restore autologous hormone production in a cervical cancer patient in Austria. Based on blood, ultrasound and cytological examinations, not to mention the patient’s personal well-being, functionality of the retransplanted tissue could be demonstrated even at 6 months after the procedure. Finally, the authors would like to highlight the importance of informing and consulting young patients with tumor diseases on the various possibilities of fertility preservation.