Primordial Follicle Count in the Pathology Sample of Cortical Stripes Frozen during Fertility Preservation Procedure

Cryopreservation of ovarian cortex is a common fertility preservation option for females with cancer. To this date, there is no known quantitative measure to predict their future function.

Does primordial and pre-antral follicle count in the pathology samples adjacent to ovarian tissue freezing may use as marker of future competence.

A retrospective study using pathological slides from ovaries removed for cryopreservation. Our experienced pathologist counted the primordial and pre-antral follicles. We compared this to the number of oocytes and cortical stripes frozen in patients with and without prior chemotherapy treatment.

Ovarian cortex from ten patients during 2017. The mean age was 20.7±7 years. Five patients were diagnosed with hematopoietic cancers (2 HL, 1 NHL, 1 ALL and 1 AML), three patients with soft tissue sarcoma, one breast cancer and one underwent BMT for Familial Hemophagocytic Lymphohistiocytosis. Four patients received chemotherapy prior to the preservation procedure. The mean number of ampules frozen was 17±5.2 (each ampule with 10 cortical stripes) and a mean of 2.8±2.4 oocytes were frozen in the procedure. The mean number of primordial follicles counted was 15.2±9.0. No correlation was found between the pathological count and the number of actual stripes and oocytes frozen. There was a trend towards higher primordial follicles count in patients without chemotherapy prior to the preservation procedure (18.2 vs. 10.8, NS).

In our small sample size, primordial follicle did not correlate with the number of mature oocytes found in the IVF lab and with the number of cortical samples frozen for future use.