Surgical management of unilateral oophorectomy for ovarian tissue cryopreservation in high-risk children and adolescents with varied backgrounds

Purpose Fertility preservation (FP) for children is still challenging due to an information gap. In particular, there is little information about the surgical aspects of ovarian tissue cryopreservation (OTC) for children. In the present study, the appropriateness of preoperative management and the criteria of our cases were investigated with the aim of establishing a safe OTC procedure. Methods A total of 25 girls who underwent OTC from November 2015 through May 2020 were retrospectively analyzed with IRB approval. Results The median age of the patients was 13 (1-17) years. The medical indications were varied (e.g., leukemia, lymphoma, brain tumor), and included rare diseases. Seventeen cases (68%) underwent OTC during chemotherapy or radiotherapy, and 21 (84%) had comorbidities. All cases underwent ovarian tissue retrieval (OTR) with laparoscopy, and the median operating time was 64 (36-97) min, with little bleeding. Although two had complications, all patients started treatment on schedule. The median WBC and CRP increases a day after OTR were 0 (- 4400 to + 5200)/mu l and 0.21 (- 0.2 to 0.87) mg/dl, respectively, with no complications. Conclusion As long as the preoperative criteria are met, OTC could be possible even for children with a severe blood condition. In such cases, the degrees of the WBC and CRP elevations are useful to assess surgical infection.

Automated summary

This study retrospectively analyzed 25 cases of ovarian tissue cryopreservation surgery in girls, finding that there was little bleeding during the operation, most cases underwent surgery during chemotherapy or radiotherapy, and the preoperative assessment criteria were met.