Cryopreservation of ovarian tissue has been demonstrated to effectively preserve fertility against gonadotoxic treatments. However, its efficacy in slowing ovarian aging has remained unclear.
This study aimed to assess the feasibility of cryopreserving ovarian tissue to extend reproductive lifespan and delay menopause through autotransplantation near menopause.
Utilizing existing biological data on follicle loss rates, a stochastic model of primordial follicle depletion was developed. This model aimed to determine the extent of delay in menopause (designated as D) achievable through ovarian tissue cryopreservation and transplantation near menopause. Variables considered included: (1) age at ovarian tissue harvest (21–40 years), (2) quantity of ovarian cortex harvested, (3) transplantation methodology (single vs. multiple procedures), and (4) post-transplant follicle survival rates (40% [conservative], 80% [improved], 100% [ideal or hypothetical]).
The model indicated that for most women under 40 years old, ovarian tissue cryopreservation and transplantation could substantially delay menopause, particularly if post-transplant follicle loss is minimized. For instance, a woman with median ovarian reserve who cryopreserves 25% of her ovarian cortex at age 25 and experiences 40% follicle survival after transplantation may expect a delay in menopause (D) of approximately 11.8 years, extending to 15.5 years with 80% survival. Notably, distributing the same tissue across multiple transplants significantly enhances the benefit. For example, fractionating transplants into 3 or 6 procedures could delay menopause by 23 or 31 years, respectively, under the same conditions. This postponement could reach 47 years with improved post-transplant follicle survival rates of 80%.
This model suggests that with early adult tissue harvesting and advanced transplant techniques, significant postponement of menopause and potentially extension of fertile lifespan can be achieved through ovarian tissue cryopreservation and transplantation in healthy women.
