Background: Fertility preservation is an essential part of cancer management mandated by international guidelines1. Ovarian tissue cryopreservation and grafting is now acknowledged as an important and successful fertility preservation strategy. It is no longer considered experimental2-5. Tissue cryopreservation is the only option for pre-pubertal patients and for post-pubertal at-risk patients in whom gamete (mature eggs, sperm) cryopreservation, is not possible6. Testicular tissue from pre-pubertal boys is also likely to be a useful option7. Currently many young people with cancer are not offered these fertility-saving options due to lack of local resources and expertise.
Aim: This paper describes the establishment of a gonadal tissue cryopreservation (GTC) transport program, allowing local unit oncofertility service provision and referral for transport, processing and storage in an acknowledged centre of excellence.
Method: Highly specialised handling, processing and cryopreservation techniques are required to maximise opportunities for the tissue to restore fertility in the future. An information/education/instruction resource is developed for fertility and oncology units Australia-wide. Gonadal tissue that is harvested as an entire organ or as a biopsy is retrieved at the local centre. Subsequent to retrieval the gonadal tissue is transported to our national cryo-bank at the Royal Women’s Hospital (RWH), Melbourne and here, the tissue is stored for future use. Following thawing, the ovarian tissue could be used for transplantation to restore endocrine function and fertility. Subsequent grafting could be performed locally or the patient can have the grafting procedure undertaken at the RWH.
Conclusions: Provision of a comprehensive fertility preservation service, as mandated by national and international guidelines, requires accessibility to GTC, which is currently not widely available. Gonadal tissue transport would facilitate engagement and upskilling in oncofertility with high-level support from a centre of excellence, allowing expansion of patient and provider access to best-practice fertility preservation options, regardless of their geographic location.