The following is a summary of “Evaluation of ovarian reserve in young females with non-iatrogenic ovarian insufficiency to establish criteria for ovarian tissue cryopreservation,” published in the July 2023 issue of Reproductive BioMedicine Online by Zajicek et al.
Can ovarian reserve parameters predict ovarian tissue cryopreservation (OTCP) fate in non-iatrogenic premature ovarian insufficiency (POI) patients younger than 18 years? A retrospective cohort analysis was conducted at a solitary tertiary hospital between August 2010 and January 2020. About 37 patients ≤18 years old with non-iatrogenic POI were included (27 with Turner syndrome, 6 with POI of unknown etiology, 3 with galactosemia, and 1 with blepharophimosis, ptosis, and epicanthus inversus syndrome). Anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and transabdominal antral follicle count were used to evaluate ovarian reserve.
If ovarian reserve was depleted and one or more parameters were positive, fertility preservation (typically OTCP) was recommended. Follicles were enumerated in ovarian samples collected during the OTCP procedure. In 34 patients, the ovarian reserve was diminished, and 19 had at least one positive parameter. Around 14 (eleven aged ≥12 years and three aged <12) underwent OTCP, one (aged 14) underwent ovarian stimulation and oocyte cryopreservation, and four declined fertility preservation.
Follicles were detected in 11 of 14 patients (79%) who underwent OTCP with one or more positive parameters and in all those with two or more positive parameters (100%) who had undergone the procedure. The median number of follicles for patients ≥12 years and those <12 years was 27 (range: 5–64) and 48 (range: 21–75), respectively. This study demonstrates that a positive predictive value of 79% is obtained for detecting follicles when OTCP is performed on patients with one or more positive ovarian activity parameters. Incorporating this criterion into OTCP will reduce the danger of harvesting ovarian tissue with a low follicle count.