Modeling delay of age at natural menopause with planned tissue cryopreservation and autologous transplantation

• Published in: American journal of obstetrics and gynecology 2024-04, Vol.230 (4), p.426.e1-426.e8
• Main Authors: Johnson, Joshua, Lawley, Sean D., Emerson, John W., Oktay, Kutluk H.
• Format: Article
• Language: English
• Subjects: Adult; Cryopreservation; Female; fertility extension; fertility preservation; Fertility Preservation - methods; Humans; menopausal symptoms; Menopause; menopause delay; Ovarian Follicle; ovarian tissue cryopreservation; ovary; Ovary - transplantation; Transplantation, Autologous
• ISSN: 0002-9378; 1097-6868; 1097-6868
• DOI: 10.1016/j.ajog.2023.12.037

Ovarian tissue cryopreservation has been proven to preserve fertility against gonadotoxic treatments. It has not been clear how this procedure would perform if planned for slowing ovarian aging. This study aimed to determine the feasibility of cryopreserving ovarian tissue to extend reproductive life span and delay menopause by autotransplantation near menopause. Based on the existing biological data on follicle loss rates, a stochastic model of primordial follicle wastage was developed to determine the years of delay in menopause (denoted by D) by ovarian tissue cryopreservation and transplantation near menopause. Our model accounted for (1) age at ovarian tissue harvest (21–40 years), (2) the amount of ovarian cortex harvested, (3) transplantation of harvested tissues in single vs multiple procedures (fractionation), and (4) posttransplant follicle survival (40% [conservative] vs 80% [improved] vs 100% [ideal or hypothetical]). Our model predicted that, for most women aged