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Breast cancer is the most common cancer disease in women worldwide, being also the third most common incident cancer overall, with a global estimated of 1.7 million new diagnosed cases per year during 2016 [1]. Fortunately, modern breast cancer treatment achieves a high rate of cure and long-term survival today and improved survival has been continuously observed over the last 50 years, from a 50% 10-year survival in the 1960s up to 80% during the 2010s []. In general, survival of women with a breast cancer treated at early stages 0–1 reaches nearly 100%, whereas it approaches about 80%, 60%, or 20% when the disease is treated in a stages 2, 3, or 4, respectively [2].
Although breast cancer is the most common cancer presenting in women of reproductive age, only 2% of all breast cancers occur in young adult women between 20 and 34 years of age and 11% in women between 35 and 44 years of age [3].
Fertility preservation is now recognized as the most essential quality of life issue in young cancer survivors. This chapter discusses three urgent and critical problems involved with ovarian tissue cryopreservation and transplantation (cryoin-jury, ischemic tissue damage, cancer cell transmission). The risk of cancer cell transmission is a serious safety issue related to ovarian autotransplantation in cancer patient. There are three strategies, at least in theory, to mature follicles in frozen stored ovarian tissue: autotransplantation; xenotransplantation; and in-vitro culture. Recently, significant progress has been made in immature follicle culture techniques. As an alternative to ovarian tissue transplantation, whole ovary transplantation has been explored. In theory, whole intact ovary transplantation with vascular anastomosis can restore the full function of the ovary. The main challenge of whole ovary transplantation for fertility preservation is the development of effective cryotechnology for the whole organ.