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Laparoscopic unilateral oophorectomy for ovarian tissue cryopreservation in children

  • Author Footnotes
    1 Co-first authors.
    Erin E. Rowell
    Correspondence
    Corresponding author at: 225 East Chicago Avenue, Box 63, Chicago, Illinois, USA 60611. Tel.: +1 312 227 4210; fax: +1 312 227 9678.
    Footnotes
    1 Co-first authors.
    Affiliations
    Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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  • Author Footnotes
    1 Co-first authors.
    Kristine S. Corkum
    Footnotes
    1 Co-first authors.
    Affiliations
    Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
    Search for articles by this author
  • Timothy B. Lautz
    Affiliations
    Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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  • Monica M. Laronda
    Affiliations
    Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA

    Stanley Manne Children's Research Institute, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA

    Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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  • Amy L. Walz
    Affiliations
    Division of Hematology, Oncology, and Stem Cell Transplantation, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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  • Mary Beth Madonna
    Affiliations
    Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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  • Barbara A. Lockart
    Affiliations
    Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA

    Division of Hematology, Oncology, and Stem Cell Transplantation, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
    Search for articles by this author
  • Marleta Reynolds
    Affiliations
    Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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  • Author Footnotes
    1 Co-first authors.

      Abstract

      Background/Purpose

      Many survivors of childhood cancer will experience premature gonadal insufficiency or infertility as a consequence of their medical treatments. Ovarian tissue cryopreservation (OTC) remains an experimental means of fertility preservation with few reports focused on the surgical technique and postoperative outcomes for OTC in children.

      Methods

      This is a single institution, retrospective review of OTC cases from January 2011 to December 2017. Children were eligible for OTC if they had a greater than 80% risk of premature ovarian insufficiency or infertility owing to their anticipated gonadotoxic medical treatment.

      Results

      OTC was performed in 64 patients. Median age was 12 years old (range: 5 months–23 years). Nearly half (48%) of the patients were premenarchal. Laparoscopic unilateral oophorectomy was performed in 84% of patients. There were no surgical complications. In 76% of patients, OTC was performed in conjunction with an ancillary procedure. The majority (96%) of patients were discharged within 24 hours. Median time from operation to medical therapy was six days, with no unanticipated treatments delays attributable to OTC.

      Conclusions

      Laparoscopic unilateral oophorectomy for OTC can be performed safely, in combination with other ancillary procedures, as an outpatient procedure without delaying medical therapy for children facing a fertility-threatening diagnosis or treatment.

      Level of Evidence

      IV.

      Abbreviations:

      FP (fertility preservation), OTC (ovarian tissue cryopreservation), DSD (disorder of sex development), FDA (Food and Drug Administration), SCT (stem cell transplant)

      Key words

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