Cryopreservation of intact human ovary with its vascular pedicle--or cryopreservation of hemiovaries?

Cryopreservation of intact human ovary with its vascular pedicle—or cryopreservation of hemiovaries? Sir, We read with interest the manuscript of Bedaiwy et al. (2006) entitled 'Cryopreservation of intact human ovary with its vas-cular pedicle', but feel there are some important details that the authors need to address for a clearer understanding of their work. First, we do not agree with the title, which suggests that 'intact human ovary has been cryopreserved with its vascular pedicle'. Indeed, in both the title and the manuscript, the authors defined the ovaries as intact ovaries for all the steps of the cryopreservation protocol. However, after perfusion with cryoprotective agent prior to freezing, the ovaries were bisected and therefore, from this moment on, they should be called hemiovaries. Hence, the first aim of their study was not achieved as they described a protocol that allows preservation of a hemiovary, not a whole ovary, and so the title should be 'Cryopreservation of human hemiovaries'. The present title causes confusion and falsely implies that the ovary was cryopreserved with its vascular pedicle with a view to future transplantation by vascular anastomosis, which is simply not true! Moreover, in each case, one ovary was cryopreserved in the form of cortical strips and not as a whole ovary. We would also like to have more information on the methodology used to bisect the ovary, mainly regarding the vascular pedicle, as the ovary only has one ovarian artery. Second, we would like to know the size of the two intact human ovaries that were used in the study. Indeed, even though they came from older patients (44 and 46 years of age), and were cut into two parts, it seems hardly likely that they could fit into cryovials of 1.27 cm diameter. It also means that if this protocol were used for younger patients, whose ovaries have a mean size of 2.5– 3 Â 2 Â 2 cm (Motta and Balboni, 1994), the ovaries would have to be cut into more than two pieces. The cryovial used in Bedaiwy's study had a volume capacity of 5 ml but, according to Kupesic et al. (2003), the mean human ovarian volume is 10 ml in women ,30 years of age, 8.30 ml from 31 to 35 years and 6.85 ml from 36 to 40 years. Therefore, regardless of the age of patients, an intact human ovary could never fit into a 5-ml …