Futures and fears in the freezer: Danish womenʼs experiences with ovarian tissue cryopreservation and transplantation

• Published in: Reproductive biomedicine online 2020-09, Vol.41 (3), p.555-565
• Main Authors: Bach, Anna Sofie, Macklon, Kirsten Tryde, Kristensen, Stine Gry
• Format: Article
• Language: English
• Subjects: Fertility preservation; Ovarian tissue cryopreservation; Patient experiences; Qualitative study; Transplantation
• ISSN: 1472-6483; 1472-6491
• DOI: 10.1016/j.rbmo.2020.06.009

Ovarian tissue cryopreservation (OTC) and subsequent re-transplantation is gaining ground as a valid technique to preserve fertility in patients facing imminent cancer treatment. This study explores patients’ experiences with OTC and transplantation, including their reflections on long-term storage of tissue and the use of surplus tissue. Semi-structured qualitative interviews with 42 Danish women undergoing OTC between 2003 and 2018, 32 of whom had ovarian tissue transplanted. Overall, OTC was associated with positive experiences linked to the production of future-oriented hope and reproductive possibilities. It also generated a range of worries, particularly regarding hormone-sensitive cancers and the risk of re-transplanting malignant cells, and the womenʼs arduous journeys to conceive after cancer resonated through the accounts. Moreover, the women's understanding of, and access to, information about the OTC procedure and its prospects affected the ways in which they approached storage and transplantation of their frozen tissue. Finally, the interviews showed how the stored ovarian tissue was also infused with potentiality beyond the scope of reproduction, both as a remedy to restore hormonal cycles and in the imagination of the-yet-to-be-discovered potential informing the women's reflections on donation and destruction. Although OTC is a ‘hope technology’ compared with freezing of oocytes and embryos, ovarian tissue is interlinked with risk and disease and positioned as an asset beyond the scope of reproduction. Importantly, this study underscores the need for provision of specialized information, follow-up, and fertility counselling after OTC and cancer treatment.