Breakthrough in Infertility Treatment: Ovarian Cortex Transplant by Dr. Jay Mehta

The “Ghatkopar Technique” for ovarian cortex auto-transplantation is a novel, therapeutic surgical protocol developed by Dr. Jay Mehta at Shree IVF Clinic, Ghatkopar, Mumbai.

It addresses the critical challenge of reimplanting cryopreserved ovarian tissue to restore fertility.

Unlike traditional methods that transplant tissue into the forearm, this technique involves anchoring the thawed ovarian cortex directly to the Psoas muscle and creating a microvascular hematoma over the ovarian pedicle.

This specific location is the native embryological site of the ovary, offering superior vascularization and easy accessibility for future transabdominal egg pickup. The technique focuses on minimizing warm ischemia time (to less than 2–3 minutes) to prevent follicle loss. 

Patients typically see a resumption of ovarian function within 4–6 weeks and menstruation within 6–8 weeks. This is a vital fertility preservation option for women facing cancer treatments, endometriosis surgeries, or premature ovarian insufficiency.

At Shree IVF and Endometriosis Hospital, we understand that preserving fertility is not just about freezing tissue—it is about successfully putting it back. One of the biggest challenges in ovarian cortex cryopreservation is not just the freezing (vitrification) but the auto-transplantation—placing the tissue back into the body so it can function again.

Standard techniques often place tissue in the forearm or abdominal fat, which can limit future fertility procedures. That is why we have developed an eponymous new, outcome-driven protocol: “The Ghatkopar Technique.”

Here are the essential details of this advanced fertility preservation protocol:

• What it is: Ovarian auto-transplantation is a high-precision surgery to successfully put frozen ovarian tissue back into your body.

• Unique Location: Instead of putting the tissue in the forearm or fatty tissue (which others sometimes do), we place it on the psoas muscle and attach it to the main ovarian blood vessel area (ovarian pedicle).

• Why that location? This spot is the ovary’s natural, original location, giving the tissue the best blood supply possible. It also makes it easier for us to collect eggs later if you need in vitro fertilization (IVF). 

• The Secret to Success: During the attachment, we purposely create a tiny, controlled bruise (microvascular hematoma) at the site. This bruise acts like a nutrient-rich “fast-food” stop, forcing new blood vessels to grow extremely quickly.

• Speed is critical: The entire process must be done in under 3 minutes (the warm ischemia time). This lightning-fast process prevents the loss of the delicate egg cells.

• Results: Patients typically start seeing their ovarian function return in 4–6 weeks, often resuming their normal menstrual cycle in 6–8 weeks.

• Evidence-Based Success: Scientific studies (e.g., PubMed, ScienceDirect) show that successful reimplantation of the ovarian cortex can restore ovarian endocrine function in over 95% of patients, making this a highly therapeutic and effective option.

• High-Precision Surgery: The use of a 10 mm trocar ensures a minimally invasive, precise procedure.

• Ideal Candidates: Patients with Endometriosis, Cancer (Oncology), or Premature Ovarian Insufficiency (POI).

• Standard, Safe Treatment: As of 2025, this is a proven, accepted medical procedure (not experimental) available today. It offers a reliable way to get your natural hormonal function back.

• Best Chance for Survival: We put the tissue in the best possible place—right near the ovary’s natural blood supply (the Psoas muscle/ovarian pedicle). This ensures the tissue heals faster and survives longer than if it were placed in the arm or fat.

• Fast Healing & Recovery: We intentionally create a tiny “healing boost” (the microvascular hematoma) that makes the tissue accept the transplant quickly. You can often expect your menstrual cycle to return in less than two months.

• Easy Future IVF: If you decide to try for pregnancy using IVF later, this placement makes the egg retrieval process much safer and easier than if the tissue were transplanted elsewhere.

Ovarian Cortex AutoTransplantation is a super-fast, super-precise surgical method designed to maximize the survival of Primordial follicles during the transplant process.

The success of any ovarian transplant depends on angiogenesis—how quickly the tissue can grow new blood vessels.

If the warm ischemia time (the time the tissue is warm but without blood supply) exceeds 2 to 3 minutes, the ovarian cortex can suffer significant damage.

Our technique is engineered to ensure this connection happens almost instantly, allowing the tissue to regain hormonal function and fertility potential.

This entire procedure is a super-fast, high-precision surgery performed by Dr. Jay Mehta and the team at Shree IVF Clinic, using minimally invasive tools (such as the 10 mm trocar) to restore blood supply to the fragile ovarian tissue in under 3 minutes.

1. Preparing the Landing Zone (Peritoneal Preparation)

• The Goal: To choose and clean the best possible spot inside the pelvis for the new tissue.

• The Action: We gently prepare the lining of the abdominal cavity (peritoneum) that sits right over the major blood vessel area of the original ovary (ovarian pedicle). This sets up the perfect, safe location for the transplant.

2. Activating the Healing Bed (Pedicle Freshening)

• The Goal: To expose healthy tissue that is ready to bond with the new ovarian graft.

• The Action: We surgically “freshen” the surface of the ovarian pedicle for about 2 cm. This step removes any superficial layers to reveal fresh, active tissue underneath. This ensures the new ovarian cortex has maximum contact with active blood vessels.

3. Anchoring the Tissue (Graft Placement)

• The Goal: To permanently secure the thawed ovarian cortex in a stable, vascular position.

• The Action: We anchor the thin strip of ovarian cortex to the Psoas muscle, which is a large, stable muscle in the pelvis. The muscle acts like a solid foundation. We use extremely fine, specialized 4-0 Prolene sutures for this precise, delicate stitching.

4. Creating the “Healing Boost” (Microvascular Hematoma)

• The Goal: To force the tissue to grow new blood vessels immediately and rapidly. This is the key, unique step of the Ghatkopar Technique.

• The Action: We intentionally place sutures through the ovarian pedicle itself. This controlled action creates a tiny, contained pocket of fresh blood (microvascular hematoma) right underneath the transplanted tissue. This “micro-bruise” acts as a concentrated nutrient source, which rapidly signals the surrounding body to grow new blood vessels into the graft.

5. Final Stabilization (Peritoneal Overlay)

• The Goal: To protect and stabilize the entire surgical site for immediate recovery.

• The Action: The peritoneum lining we prepared in Step 1 is gently pulled back and laid over the entire anchored ovarian cortex. This covering stabilizes the tissue and the unique “healing boost” site, ensuring the new graft stays firmly pressed against the highly vascular Psoas muscle bed for optimal uptake.

The decision to suture the transplanted ovarian cortex near the ovarian pedicle is the most crucial step in the Ghatkopar technique. It is based entirely on accelerating the healing process and restoring function.

1. The Challenge: A Graft’s Lack of Native Blood Supply

The core problem is that the ovarian cortex is a thin slice of tissue without any native vascularity (no blood vessels of its own).

In the traditional technique, where the tissue is simply transplanted back into the ovarian fossa, the entire vascularity has to develop slowly from the surrounding abdominal lining (peritoneum).

This passive approach often causes delays and compromises the survival of the follicles.

2. The Solution: Creating a Microvascular Activation Site

Our technique actively intervenes to force immediate blood vessel growth:

• Microvascular Damage: We intentionally cause a controlled, tiny injury (microvascular damage) along the ovarian pedicle (the blood vessel stalk).

• The Hematoma Signal: This damage immediately creates an extremely tiny haematoma (a small, nutrient-rich bruise) under the peritoneal cover.

• Rapid Uptake: This hematoma acts as a powerful, localized signal for healing, allowing the ovarian cortex to be taken up extremely rapidly by the surrounding blood supply.

3. The Proven Outcome

This aggressive approach to restoring blood flow maximizes follicle survival and function.

In patients who have received these auto-transplants using the Ghatkopar Technique, we have observed the rapid success of the graft, with patients resuming spontaneous menstruation within 6 to 8 weeks after the procedure being performed.

The thawing process is the first critical step that ensures the survival of the follicles. Our protocol is designed to minimize damage and strictly control the time the tissue is vulnerable.

1. The Standard Thawing Process

The ovarian cortex is initially thawed using the special thawing medium provided with the manufacturer’s cryopreservation kit. This medium is formulated to safely remove the cryoprotectants used during freezing.

2. The Critical Protocol Difference

We implement a critical protocol difference to ensure safety during the transfer to the operating room (OR):

• Warm Buffer Transport: As soon as the cortex is thawed, we immediately place it into a warm buffer maintained at approximately 10°C to 12°C.

• Rapid Transfer: The tissue must then be immediately transported from the IVF laboratory to the operating theater.

3. Controlling the Ischemia Window

• Strict Time Limit: This transfer process defines the available warm ischemia time, which is strictly limited to approximately 2 to 3 minutes.

The entire operating theater setup and the surgical team must be prepared and cleared before this 2- to 3-minute window begins, ensuring the tissue is placed inside as quickly as possible.

4. Why the Tissue is Resistant (Natural Protection)

The high success rate of the transplant relies on the natural resilience of the tissue we are handling:

• Follicle Type: We are freezing the primordial follicles, which are a completely different cell type compared to a mature egg cell (oocyte).

• Resting State: The follicle is resting with very limited water content and cellular organelles, making it extremely resistant to cryoprotection damage.

• Protection from Injury: Fortunately, there is a basement membrane in the stromal tissue. This acts as a natural shield that protects the tissue from reperfusion injuries—damage that can occur when blood flow is suddenly restored to the graft.

5. Surgical Readiness

The entire scheme of events is focused on maximizing these natural advantages.

The team utilizes minimally invasive techniques, placing the tissue inside using a 10 mm trocar and completing the detailed suturing with 4-0 Prolene to ensure the entire re-implantation phase is rapid and precise.

Quick Tip: The ovarian cortex is naturally resistant to cryo-damage because primordial follicles are in a “resting state” with low water content. This makes them robust, provided the reimplantation is fast.

Fertility preservation is complex, but with the right technique, it is highly successful. At Shree IVF Clinic, we combine world-class cryopreservation with our proprietary surgical precision to give you the best chance at biological motherhood. Don’t leave your fertility to chance.

👉 Consult Dr. Jay Mehta at Shree IVF Clinic, Ghatkopar, Mumbai, to discuss if Ovarian Tissue Transplant is right for you. Call 24/7: 1800-268-4000

This is a question of scientific rigor versus surgical tradition.

• Traditional Practice:

Yes, the traditional technique for ovarian cortex auto-transplantation places the tissue under the peritoneum in the ovarian fossa. As a result, the standard procedure involves covering the anchored tissue with peritoneum.

• Our Current View (Scientific Honesty):

At Shree IVF Clinic, we follow this step (covering the tissue with the peritoneum after anchoring), primarily because it provides excellent mechanical stabilization of the entire ovarian cortex over the Psoas muscle and the microvascular activation site.

• Clinical Significance:

However, in the field of reproductive medicine, we acknowledge a gap: we do not currently know the actual clinical significance of covering the entire autotransplanted tissue in terms of long-term follicle survival or function.

We continue the practice as a safe measure for graft stability while research continues.

The Ghatkopar Technique offers a superior pathway to fertility preservation and restoration for a wide range of patients due to its high focus on graft survival and future accessibility.

• Universal Applicability: This technique can benefit every patient who is undergoing ovarian cortex auto-transplantation.

• Status Independent: It can be used regardless of whether the patient’s ovary is currently preserved or not preserved.

• High-Risk Patient Groups: It is a vital option for almost all patients getting this done, particularly those with conditions that severely threaten their ovarian reserve:

• Patients with severe endometriosis (especially those requiring complex or repeat surgeries).
• Patients facing treatment for any form of malignancy (cancer), where chemotherapy or radiation will destroy ovarian function.
• Women with Premature Ovarian Insufficiency (POI) looking to restore natural hormonal function.

Note: Regardless of whether you have endometriosis or a malignancy, “The Ghatkopar Technique” offers a viable pathway to restore your body’s natural hormone balance and future fertility.

Our choice of the psoas muscle/ovarian pedicle site is a strategic decision rooted in embryology, physiology, and future clinical care.

1. Superior Vascularity Development

• Native Location:  This region is the native location of the ovary from an embryological perspective.

It is scientifically believed that once tissue has been repositioned and auto-transplanted along this original anatomical “track,” the development of new blood vessels (vascularity) is naturally much better and more sustained.

• Efficiency: While the forearm or abdominal fat might be superficially easier sites, they lack the high, complex vascular network necessary for the graft to “take” quickly and efficiently.

2. Safety and Future Accessibility

• Least Damage: Placing the tissue here is the most accessible internal location with the least risk of damage to the bowel.

• Future IVF: Most critically, this location allows for easy and safe transabdominal percutaneous egg pickup should the patient desire fertility treatment (IVF) in the future.

Repositioning the ovarian cortex back into the forearm or abdominal fat would make safe, non-surgical egg retrieval virtually impossible, severely limiting the patient’s future options.

Note: In our unit, we have never attempted to reposition the ovarian cortex back into the forearm or the abdominal fat due to the clear disadvantages in vascularity and future clinical access.