Ovarian tissue freezing may halt menopause indefinitely

The possibility of delaying menopause in healthy women, thus extending fertility and potentially avoiding the health risks and discomforts linked to decreasing estrogen levels, is captivating a group of scientists.

Published in the American Journal of Obstetrics & Gynecology, the study utilizes a mathematical model combined with data from hundreds of past ovarian cryopreservation and transplantation procedures, as well as molecular research on ovarian follicle behavior in ovarian tissue. This approach is used to estimate the potential duration by which the procedure could delay menopause in healthy women under various conditions.

Kutluk Oktay, MD, PhD, an ovarian biologist who is director of the Laboratory of Molecular Reproduction and Fertility Preservation at Yale School of Medicine (YSM),developed and performed the world's first ovarian transplant procedure with cryopreserved tissue for a patient with a medical indication in 1999, now sees a future in which healthy women could use this process of freezing tens of thousands of eggs within the ovarian tissue to prevent menopause for as long as several decades -- or even prevent its onset altogether.

"For the first time in medical history, we have the ability to potentially delay or eliminate menopause," said Oktay.

In this outpatient procedure, surgeons laparoscopically extract either an entire ovary or portions of its outer layer, which harbors hundreds of thousands of primordial follicles containing immature eggs which are then frozen using a specialized technique and stored at temperatures as low as negative 320 degrees Fahrenheit, ensuring their preservation for future use. Years later, these tissues can be reimplanted into the patient through surgery or a simpler procedure. Within days, the tissue reconnects with blood vessels, eventually restoring ovarian function within three months.

"Women are also frequently deferring pregnancy until later in life for professional or social reasons. The ability to freeze and later transplant ovarian tissue…offers a way to extend their fertile lifespan." concluded Oktay.

Furthermore, the model offers insight into the ideal amount of ovarian tissue to collect. The more tissue a surgeon removes, the longer the procedure can potentially delay menopause.

References: Joshua Johnson, Sean D. Lawley, John W. Emerson, Kutluk H. Oktay. Modeling delay of age at natural menopause with planned tissue cryopreservation and autologous transplantation. American Journal of Obstetrics and Gynecology, 2024; DOI: 10.1016/j.ajog.2023.12.037