Preserve Your Fertility with Ovarian Tissue Cryopreservation (OTC) at India’s Top Endometriosis Centre

As a reproductive medicine specialist and a gynecologist focused on complex cases, I know that an advanced endometriosis diagnosis can feel overwhelming, especially when considering your fertility.

For too long, aggressive surgeries for severe endometriosis were seen as a double-edged sword—necessary for health, but risky for your ovarian reserve.

I want to be absolutely clear: Ovarian Tissue Cryopreservation (OTC) is a game-changer. It is no longer considered an experimental technique.

Here at our unit, the largest multidisciplinary office for advanced endometriosis in India.

We have incorporated OTC into our standard surgical approach. This therapeutic technology is now an absolutely vital tool in our armamentarium to manage the fertility outcomes for patients undergoing excision surgery for advanced endometriosis.

OTC allows us to preserve the ovarian cortex, the part of the ovary containing thousands of your immature eggs, effectively safeguarding your future ability to conceive.

Ovarian Tissue Cryopreservation (OTC) is an advanced fertility preservation technique that involves freezing a part of the ovarian cortex before surgery or treatment that may damage the ovaries.

It is no longer experimental and is now recognized as a therapeutic technology that helps preserve fertility, especially in women with endometriosis or low ovarian reserve.

Deciding to go ahead with ovarian tissue freezing (cryopreservation) is deeply personal and is made only after a careful, detailed consultation.

Based on our clinical experience and scientific data, we typically consider OTC for patients who meet the following inclusion criteria:

• Low AMH (Anti-Mullerian Hormone) Levels: This test is a crucial indicator of a diminished ovarian reserve, signaling an expected compromise to your future egg supply.

• Redo Surgeries: If you are undergoing a second or subsequent surgery for endometriosis, the risk to your remaining ovarian tissue is significantly higher.

• Any procedure where severe ovarian compromise is expected: This includes extensive disease, endometriomas (endometriosis cysts) that require major resection, or bilateral ovarian involvement.

• When Oocyte Freezing is not possible, due to Low Yield: If we anticipate that the standard egg freezing process will yield very few eggs, or if immediate surgery is required, OTC becomes the superior option for fertility preservation.

Ovarian tissue cryopreservation as an option for fertility preservation in young unmarried girls

This is one of the most important questions a patient can ask, and I want to assure you that patient safety is our absolute priority.

Because endometriosis is a benign (non-cancerous) condition, the risk of transferring malignant cells is minimal compared to cancer patients. However, we follow an extremely rigorous, multi-step screening protocol to virtually eliminate this risk.

1. Pre-Surgical Ultrasound Mapping:

We perform a highly detailed pre-surgical ultrasound, which we call mapping. With this advanced technology, we can differentiate between typical endometriosis tissue and any potentially malignant-looking tissues.

2. Detailed Histopathological Evaluation During Surgery (Frozen Section Analysis):

Once the affected cyst or tissue is removed, a critical step is performed immediately in our unit. We use a specialized cryotome machine to freeze and slice a sample of the planned ovarian tissue.

A pathologist then performs a detailed, frozen section analysis on this sample. This allows us to rule out any sign of malignancy before the remaining tissue is sent for cryopreservation.

3. Post-Procedure Histopathology:

A final, detailed histopathological examination is done by our specialized microbiologist and pathologist on the entire extracted tissue.

By doing this detailed, multi-layered evaluation, the possibility of re-introducing any type of malignant cells during the autotransplantation in the future is extremely limited.

If you or a loved one is facing advanced endometriosis surgery or other fertility-compromising conditions, don’t wait to explore fertility preservation options.

At our center, we combine expertise, compassionate care, and cutting-edge OTC technology to safeguard your fertility future. Schedule a personalized consultation with Dr. Jay Mehta, one of India’s leading specialists in ovarian tissue cryopreservation and reproductive immunology, for a personalized assessment and treatment plan today to discuss how ovarian tissue cryopreservation can help you achieve your family-building goals.

Ovarian tissue cryopreservation is a technical and challenging process that requires extreme expertise and state-of-the-art equipment. This is the precise, meticulous protocol we follow at our unit.

Here are the standard steps involved in ovarian tissue cryopreservation

We currently no longer perform the slow freezing protocol for ovarian cortex cryopreservation. It was a widely followed technique that was predominantly done in order to make sure that the freezing protocol does not cause any damage to the ovarian cortex.

However, with advancements in cryotome technology and the development of improved cryoprotectant solutions, we have transitioned to a more advanced approach.

Ovarian cortex vitrification has now become our preferred method, offering significant benefits over the traditional slow freezing protocol.

For almost every type of ovarian cortex cryopreservation, we now strictly follow the vitrification protocol.

Vitrification is a type of ultra-rapid freezing that instantly transforms the tissue’s internal water into a glass-like solid, completely bypassing the damaging formation of ice crystals. This process dramatically improves the viability of the primordial follicles—your future eggs—within the tissue, leading to better outcomes.

Our goal isn’t just to preserve tissue; it’s to restore your function and make a healthy pregnancy possible. We look at the outcomes in terms of global data and our own clinical expertise:

What are the reported pregnancy and live birth rates after ovarian tissue transplantation?

Globally, OTC and subsequent transplantation have been tremendously successful, with more than 200 live births reported across the world.

This is why major organizations like the American Society for Reproductive Medicine (ASRM) now classify this as a therapeutic approach, not an experimental one. This success validates our commitment to this complex therapy.

How Soon Does Ovarian Function Return After Transplantation?

Once the cryopreserved tissue is thawed and transplanted to an orthotopic site (the correct anatomical location), we typically see the ovarian function and natural menstruation established within approximately 4 to 8 weeks. This is often an emotional moment for patients, as it signifies the return of natural hormonal balance.

What is the longevity of graft function after transplantation?

The transplanted ovarian graft, based on the number of tissue pieces implanted, is generally expected to function for approximately 4 to 8 years.

The total longevity is also influenced by whether the patient later requires hormonal stimulation or can achieve natural conception.

We believe that making an informed decision requires a complete picture, including the challenges involved.

What Are the Surgical Risks Associated with Ovarian Tissue Cryopreservation?

The main surgical concern is that OTC is a highly capital-intensive and technically challenging procedure. It requires an extreme amount of expertise to perform correctly, both in the operating theater and in the IVF lab.

This is precisely why very few centers—even worldwide—have developed the necessary, comprehensive expertise to execute this procedure correctly and safely.

Our unit’s unique specialization in advanced endometriosis surgery and our integrated IVF lab allow us to maintain the highest standards of care.

Are There Adverse Effects Related to Cryopreservation and Grafting?

While rare, there is a possibility of the transplanted ovarian tissue being rejected, even when the procedure is done perfectly.

This is an ongoing area of research, as we are constantly working to identify the absolute best site for autotransplantation to ensure maximum blood supply and integration.

We understand that cost is a major consideration, and as a national referral unit treating a large volume of patients for complex conditions like endometriosis and adenomyosis, we strive to keep the process transparent and value-driven.

The total cost for your Ovarian Tissue Cryopreservation (OTC) program is generally comprised of two main components:

1. The Procedure Cost (Extraction and Initial Processing):

The primary cost is calculated and decided by us predominantly based on the amount of ovarian cortex that is successfully extracted and cryopreserved.

Because the surgical and laboratory work involved is highly specialized and requires significant expertise and cutting-edge equipment (like the cryotome), the complexity and volume of the tissue processed determine the initial fee.

2. Annual Maintenance Cost (Storage):

To ensure your preserved tissue remains safe and viable in our specialized liquid nitrogen canisters, there is a recurring annual maintenance cost of approximately ₹50,000 per patient.

It’s important to remember that when done correctly, OTC is considered to be much more cost-effective compared to other methods like oocyte banking, as the tissue yield (the total number of potential eggs stored) is significantly higher. This high yield offers a better long-term investment in your future fertility.

While the most common application is in cancer patients facing gonadotoxic treatment, we are also leveraging this technology in other critical areas:

What is the Role of Ovarian Tissue Cryopreservation in Pediatric Patients?

For young girls in the pediatric or pubertal range, OTC is often the only viable fertility preservation option, as they are not candidates for egg freezing.

Currently, its primary application in this group is limited to cases of malignancy and severely debilitating congenital anomalies.

• OTC is therapeutic: Ovarian tissue cryopreservation is a proven, non-experimental therapeutic technology for fertility preservation.

• Ideal for Advanced Endometriosis: It is especially crucial for patients with severe endometriosis, women with low AMH undergoing repeat or high-risk surgeries when egg freezing is not feasible, or those requiring redo surgeries where the ovarian reserve is highly compromised.

• Safety First: Our unit employs rigorous pre-surgical mapping and detailed histopathological frozen section analysis to rule out any malignant cells before preservation.

•  Vitrification is Key: We use the advanced vitrification (ultra-rapid freezing) protocol for superior follicle viability and better long-term outcomes.

• High Success Rate: Global data reports over 200 live births following ovarian tissue transplantation.

• Long-Term Function: The transplanted graft can restore ovarian function and menstruation in 4-8 weeks and may last for 4-8 years.

• Cost-effective: Compared to other fertility preservation methods, particularly in challenging ovarian cases, OTC is much more cost-effective.

Don’t let the shadow of advanced endometriosis limit your family-building dreams. Our unit in India offers world-class, evidence-based care, making us the trusted choice for this specialized procedure.

Schedule your consultation with Dr. Jay Mehta and our multidisciplinary team today at 1800-268-4000. We’re here to give you the clarity, confidence, and cutting-edge medical support you need to make an informed decision about your future.