Ovarian tissue cryopreservation in girls and adolescents at risk of gonadotoxicity: a 15-year experience in 159 patients from a referral program

Autores de IIS La Fe

• María Del Mar Andrés Moreno

  Autor

• Javier Gómez-Chacón Vilalba

  Autor

• Patricia Gómez Torres

  Autor

• Pedro José Fernández Colom

  Autor

• Jorge Cortes Saez

  Autor

• Alfredo Marco Macián

  Autor

• Helena Martínez Sánchez

  Autor

• Bárbara Torres Guerola

  Autor

• María Teresa Tormo Alcañiz

  Autor

• Mª Pilar Morillas Amat

  Autor

• Patrocinio Polo Sanchez

  Autor

• José María Rubio Rubio

  Autor

• Edurne Novella Maestre

  Autor

• Adela Cañete Nieto

  Autor

• Francisca Moreno Macián

  Autor

Participantes ajenos a IIS La Fe

• Lis V.M.

Grupos

• Enfermedad de Parkinson y Trastornos del Movimiento

• Investigación Clínica y Traslacional en Cáncer

• Investigación Traslacional en Genética

• Medicina Fetal y Reproductiva

Abstract

Purpose: To report a 15-year single-center experience of a pediatric fertility preservation program based on ovarian tissue cryopreservation (OTC), focusing on patient selection, program logistics, and endocrine and reproductive outcomes with explicit consideration of age- and treatment-related evaluability. Methods/patients: Retrospective observational study including all girls and adolescents who underwent OTC between 2010 and 2025. Eligibility was based on structured gonadotoxic risk assessment integrating diagnosis, alkylating-agent exposure, radiotherapy fields/doses, and hematopoietic stem cell transplantation (HSCT). Outcomes were analyzed descriptively. Ovarian function was assessed in patients considered evaluable at last follow-up (aged = 13 years, off treatment, and with endocrine follow-up available). Results: A total of 159 patients underwent OTC (median age at OTC 11.0 years). Malignant diseases accounted for 131/159 (82.3%), including leukemias/lymphoblastic lymphomas 35/159 (22.0%) managed in the context of HSCT, and other malignancies 96/159 (60.4%); non-malignant conditions accounted for 28/159 (17.7%). OTC was coordinated with another procedure under anesthesia in 106/159 (66.6%), and ovarian transposition was performed in 27/159 (17.0%) when abdominal and/or pelvic radiotherapy represented the main gonadotoxic risk. Among patients evaluable for ovarian function (n = 83), primary ovarian insufficiency was diagnosed in 36/83 (43.4%) (36/159, 22.6% overall); hormone replacement therapy was administered in 31/36 (86.1%). Conclusion: A structured, risk-based OTC program can be integrated into pediatric oncology care with close logistical coordination. Clear definition of evaluability denominators and long-term multidisciplinary follow-up are essential for accurate interpretation of endocrine outcomes in this high-risk population. © The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO) 2026.

Keywords

• Fertility preservation; Gonadotoxicity; Hematopoietic stem cell transplantation; Ovarian tissue cryopreservation; Pediatric oncology; Premature ovarian insufficiency