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Ovarian tissue cryopreservation: freezing part of an ovary before treatment | CION Cancer Clinics
Ovarian tissue freezing is a keyhole operation that removes part or all of one ovary before cancer treatment, so its egg-holding outer layer can be frozen. It needs no hormone injections and can be done at any age, which is why it is discussed for young girls and for women whose treatment cannot wait. This page explains the operation, who it suits, how it compares with egg freezing, and its limits. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is ovarian tissue freezing, and who is it for?
- What happens during ovarian tissue freezing?
- In which situations do teams usually consider it?
- How does ovarian tissue freezing compare with egg freezing?
- What do families often misunderstand about ovarian tissue freezing?
- Who is ovarian tissue freezing not suitable for?
- What do the terms used by the fertility team mean?
- Common questions about ovarian tissue freezing
The short answer
What is ovarian tissue freezing, and who is it for?
Ovarian tissue freezing is a keyhole operation that removes part or all of one ovary before cancer treatment. The outer layer, which holds thousands of immature eggs, is cut into thin strips and frozen. Years later, the strips can be put back into the body to try to restore fertility and hormones.
Why it exists alongside egg freezing
Egg freezing needs about two weeks of hormone injections and a body that has gone through puberty. Ovarian tissue freezing needs neither. That makes it the option most often discussed for young girls, and for women whose cancer treatment cannot wait for injections.
How established it is
For many years it was treated as experimental. Major fertility bodies now regard it as an accepted option for suitable patients, and babies have been born after the tissue was returned. The experience in children is smaller, and not every fertility centre in India offers the laboratory freezing or the later return of tissue.
Ask any centre directly whether it both freezes and re-implants ovarian tissue, and how many times it has done so. This page cannot tell you whether it is right for you.Step by step
What happens during ovarian tissue freezing?
Planning with both teams
Your oncologist, a gynaecological surgeon and the fertility laboratory agree the date. Blood tests check that the operation is safe with your current counts.
The keyhole operation
Under general anaesthetic, the surgeon makes a few small cuts in the abdomen and removes a piece of ovary or one whole ovary. Most women go home the same day or the next.
Freezing in the laboratory
The outer layer is separated, cut into thin strips and frozen slowly. A small piece is often checked under the microscope for cancer cells.
Returning the tissue later
When a pregnancy is safe, strips are thawed and stitched onto the remaining ovary or nearby in a second keyhole operation. Hormones and periods may return some months later.
Not sure whether this applies to you?
Ask an oncologistWhen it is discussed
In which situations do teams usually consider it?
These are the groups for whom tissue freezing most often comes up. Whether it applies to you is a decision for your team.
Girls before puberty
A young girl's ovaries cannot respond to hormone injections, so egg freezing is not possible. Tissue freezing is currently the main option discussed. Parents give consent, and the child is included as far as her age allows.
No time for injections
When treatment has to start within days, tissue can be removed in a short operation without waiting for eggs to ripen.
Surgery already planned
If you are having an abdominal operation for your cancer anyway, tissue can sometimes be removed under the same anaesthetic. This needs planning with the laboratory before the day.
Treatment very likely to stop the ovaries
High-dose chemotherapy before a bone marrow transplant, or radiation to the whole abdomen, carries a high risk to the ovaries. Tissue freezing may be offered alongside other options.
Side by side
How does ovarian tissue freezing compare with egg freezing?
Ovarian tissue freezing
Egg freezing
A keyhole operation under general anaesthetic
Hormone injections and a needle collection under sedation
Can be done within days, at any age
Needs about two weeks and a body past puberty
May restore periods and natural hormones for a time
Does not affect hormones after treatment
Needs a second operation to return the tissue
Eggs are used later through IVF
Offered at fewer centres
Widely available at fertility centres
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Commonly believed
What do families often misunderstand about ovarian tissue freezing?
"Removing an ovary will bring on menopause straight away."
When one ovary or part of one is removed, the other ovary keeps working until cancer treatment affects it. The operation itself does not usually cause menopause.
"Putting the tissue back is always safe."
In some cancers, especially leukaemia, the frozen tissue could contain cancer cells. Returning it could bring the cancer back. That is why the tissue is tested, and why it may not be returned in some cancers until safer methods exist.
"The tissue will work for the rest of her life once it is returned."
Returned tissue usually works for a limited time, often a few years, because only part of the egg supply survives freezing and grafting. It is a window, not a permanent replacement.
"She is too young to worry about children."
A child cannot decide this for herself yet, which is exactly why the question falls to parents now. Hearing about the option does not commit you to it.
Honest limits
Who is ovarian tissue freezing not suitable for?
It is not usually offered where the cancer is likely to be inside the ovary itself, such as ovarian cancer, or where the cancer spreads to the ovaries often. The risk of freezing cancer cells along with the eggs is too high.
When the operation is not safe now
Any operation carries risks: bleeding, infection and the risks of a general anaesthetic. A woman or girl with very low blood counts, a serious infection or a bleeding problem may not be fit for surgery before treatment. The team will check this before planning anything.
When the evidence is thinner
Studies are still small in women past their mid-thirties, where the egg supply in the tissue is lower, and in girls, where fewer tissue returns have been done so far. Your fertility specialist can tell you honestly how much is known for someone of your age.
What your team weighs
They look at the cancer type, how soon treatment must start, your age and fitness, and whether a centre nearby can store and later return the tissue. The decision about whether to have the operation is made with them.
Words you may hear
What do the terms used by the fertility team mean?
- Ovarian cortex
- The outer layer of the ovary, where most of the immature eggs sit. This is the part that is frozen.
- Cryopreservation
- Freezing and storing tissue at very low temperatures so it can be used years later.
- Laparoscopy
- Keyhole surgery done through a few small cuts using a camera.
- Transplantation
- Here, returning the thawed strips of ovarian tissue to the body in a second operation.
- Minimal residual disease
- A very small number of cancer cells that remain but cannot be seen on scans. It is the reason tissue is tested before being returned.
Questions we are asked
Common questions about ovarian tissue freezing
Is ovarian tissue freezing available in India?
A small number of fertility centres in India offer it, and fewer offer both freezing and the later return of tissue. Availability changes. Ask the centre directly what it does, how often, and where the tissue would be stored. Your cancer team can help you find a centre that works with them.
How soon after the operation can chemotherapy start?
Because it is keyhole surgery, recovery is usually quick. Your surgeon and oncologist agree when treatment can begin, which depends on how the wounds are healing and how urgent the treatment is. Ask both of them to confirm the date before the operation.
Can my daughter have this before she gets periods?
Yes, that is one of the main reasons it exists. A girl before puberty cannot have egg freezing. You give consent as parents. The team should also explain it to your daughter in words that suit her age, because the tissue will one day be hers to decide about.
Will the tissue be tested for cancer?
Usually a small piece is examined under the microscope when it is frozen, and more testing may be done before it is ever returned. Testing lowers the risk but cannot remove it completely. That is why the cancer type matters so much in the decision.
Can the tissue be used to get pregnant naturally?
In some women, yes. Once the tissue is returned and starts working, periods may return and a natural pregnancy is possible. Some women still need IVF. Nobody can say in advance which will happen, or how long the tissue will keep working.
Can this be combined with egg freezing?
Sometimes. Immature eggs found in the removed tissue can occasionally be collected and matured in the laboratory. In some women, egg freezing can follow the operation if time allows. Ask the fertility specialist whether a combined plan is possible.
How long can the tissue be stored?
Frozen tissue can stay usable for many years, which matters for a young girl who may not use it until adulthood. Storage is charged every year. Ask how renewal works and who takes over the decisions once your daughter is an adult.
Does the operation leave a big scar?
Keyhole surgery leaves a few small scars, usually one near the belly button and one or two lower on the abdomen. They fade over time. If the tissue is removed during a larger cancer operation, it uses the same cuts as that operation.
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Sources
- National Cancer Institute — Fertility issues in girls and women with cancer
- American Cancer Society — Fertility and sexual side effects
- Macmillan Cancer Support — Fertility and cancer
- NICE — Fertility problems: assessment and treatment (CG156)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Egg Freezing Before Cancer TreatmentThe injection-based option, step by stepOvarian Transposition Before Pelvic RadiationMoving the ovaries away from radiation insteadWhy the Window Closes Before Treatment StartsWhy timing decides which option is possibleAnaesthesia for Cancer SurgeryWhat a general anaesthetic involves
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