Safety of laparoscopic surgery for ovarian tissue cryopreservation in pediatric patients.

BACKGROUND

Ovarian tissue cryopreservation (OTC) is recognized as the only option for fertility preservation in children. However, surgery for OTC in pediatric patients carries risks differing significantly from those in adults, and little is known about its safety. As a representative fertility preservation center in Japan, we investigated safety and feasibility of surgery for OTC in children.

METHODS

The survey period was from November 2015 to November 2024. Data were collected retrospectively from the electronic medical records of 0- to 17-year-old girls who underwent OTC at our hospital. Age, primary disease, height, weight, comorbidities, operation time and blood loss, surgical complications, and changes in blood data of subjects were verified.

RESULTS

Mean age of the 110 patients was 8.9 ± 5.0 years. Of the patients, 89 (80.9%) had malignant diseases, with leukemia (n = 21. 19.1%) as the most common underlying disease. Twenty patients (18.1%) had recurrent disease and 84 (76.4%) were undergoing surgery during chemotherapy and/or radiotherapy. Mean body mass index was 17.0 kg/m2, and some patients were thin and had delayed physical development. Ninety-two patients (83.6%) showed low white blood cell counts immediately before surgery. Laparoscopic unilateral oophorectomy was performed in all cases, with an average operation time of 55.5 ± 14.3 min and an average blood loss of 2.9 ± 8.4 g. One patient (0.9%) developed fever as a surgical complication.

CONCLUSIONS

These results suggest that laparoscopic surgery for OTC in children can be performed safely with the cooperation of experts from multiple medical fields.