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Could ovarian tissue freezing delay menopause? Here’s what research shows
Scientists at Yale School of Medicine published research on possible outcomes when menopause is delayed via ovarian tissue freezing
A new paradigm around the biological processes of menopause is capturing the attention of scientists in the US.
A small group of researchers in the US are analysing the possibility of delaying menopause in healthy women, allowing them to extend their child-bearing years, and perhaps even forestall some of the health risks and uncomfortable symptoms.
This, however, could be controversial. While some people may believe that such research could lead to life-changing benefits for women, others may think the menopause should not be “pathologised” by medical science.
At Yale School of Medicine, Kutluk Oktay, an ovarian biologist who is director of the Laboratory of Molecular Reproduction and Fertility Preservation, recently added a new chapter to this conversation by publishing research on various possible outcomes when menopause is delayed in healthy women via ovarian tissue freezing.
Oktay, who developed and performed the world’s first ovarian transplant procedure with cryopreserved tissue for a patient with a medical indication in 1999, sees a future in which healthy women could use this process of freezing tens of thousands of eggs within the ovarian tissue to stave off menopause for as long as several decades — or even prevent its onset altogether.
“For the first time in medical history, we have the ability to potentially delay or eliminate menopause,” he said.
A mathematical model to predict outcomes for delayed menopause
Using data from hundreds of previous ovarian cryopreservation and transplantation procedures and molecular studies of how ovarian follicles behave in ovarian tissue, Oktay and his colleagues built a new mathematical model to predict how long the surgery could potentially delay menopause under a range of circumstances in healthy women.
Since Oktay performed the first successful transplantation with cryopreserved tissue, ovarian tissue cryopreservation has been successfully used in cancer patients to preserve their fertility before their treatments, which can often permanently damage the egg reserve in the ovaries and trigger menopause.
During this outpatient procedure, a surgeon laparoscopically removes the whole ovary or layers of the outer portion, which contains hundreds of thousands of dormant, immature eggs, known as primordial follicles.
These tissues are then stored in sealed containers after being frozen with a specialised process and kept as low as negative 320 degrees Fahrenheit.
Freezing ovarian tissue with this specialised process preserves it for later use. At some point in the future, the surgeon reimplants the thawed tissue into the patient either laparoscopically or with a simple procedure, using methods developed by Oktay, that places the tissue under the patient’s skin while intravenous sedation is administered.
Within three to 10 days after that, this transplanted tissue regains connections with the surrounding blood vessels and restores ovarian function in about three months.
The recently published mathematical model focusing on healthy women undergoing ovarian tissue cryopreservation considers multiple factors, including the age at which a patient gets the procedure, which plays a significant role in how long menopause can potentially be delayed.
“The younger the person, the larger number of eggs she has, as well as the higher the quality of those eggs,” Oktay said.
The model accounts for women between the ages of 21 and 40. Beyond age 40, data show that the procedure is unlikely to delay menopause for a woman with average egg reserve, but this can change with the development of more efficient freezing and transplantation methods in the future.
Furthermore, the model offers insight into the ideal amount of ovarian tissue to collect. The more tissue a surgeon removes, the longer the procedure can potentially delay menopause. However, the removal of too much tissue can lead to early menopause.
“This model gives us the optimum amount of tissue to harvest for a person of a given age,” explained Oktay.
The model also takes into account the healing process after a surgeon returns the harvested ovarian tissue to the patient. During this healing process, some of the primordial follicles are lost.
Studies on animal models show that as many as 60 per cent of primordial follicles do not survive post-transplantation, leaving 40 per cent that are viable. With newer technologies, Oktay said that he believes surgeons can attain a survival rate of up to 80 per cent.
As the procedure continues to improve, he hopes to eventually achieve a 100 per cent survival rate. Thus, the model accounts for survival rates ranging from 40 per cent to 100 per cent.
Additionally, through transplanting portions of the harvested tissues over several procedures, the research indicates that menopause can be delayed even longer. For example, the team’s model shows that returning a third of the outer portion of the ovary over each of three procedures delayed menopause longer than returning all of the tissue through one surgery.
Based on the model, Oktay predicts that for most women under 40, ovarian cryopreservation can significantly delay menopause. And for women under 30, the procedure may be able to prevent menopause altogether.
Because many women lose their ability to become pregnant sooner than they desire, ovarian cryopreservation could be an appealing option for them, said Hugh S. Taylor, professor and chair of obstetrics, gynaecology and reproductive sciences at Yale School of Medicine.
“Women are also frequently deferring pregnancy until later in life for professional or social reasons,” Taylor added. “The ability to freeze and later transplant ovarian tissue offers a way to extend their fertile lifespan.”
Does delaying menopause via cryopreservation offer health benefits?
Delaying menopause with ovarian cryopreservation may confer certain health benefits associated with a later menopausal age.
Based on new research by Oktay and his colleagues, around 11 per cent of women experience late-onset natural menopause or menopause after age 55.
Studies show that women who experience menopause later may live longer and have a lower risk for a range of conditions, including cardiovascular disease, dementia, retinal disease, depression and bone loss. However, uncertainty remains over whether later menopause actually reduces those health risks.
Oktay hypothesises that those risks also may be mitigated in healthy women who delay menopause via ovarian tissue cryopreservation.
If risk for such chronic diseases is reduced in healthy women who undergo this procedure, it could be a significant benefit. However, Taylor said that “additional research is needed to determine long-term benefits as well as risks.”
In ongoing research, Oktay and his team are studying the outcomes of healthy women who have opted to delay menopause through this procedure.
Publication of these studies is far in the future, but in the meantime, the researcher said the mathematical model offers a starting point for considering the feasibility and possible benefits of forestalling menopause in healthy women.
Australia’s drug advisory committee has recommended wider funding of triptorelin for women with breast cancer or endometriosis.
The recommendation comes after AstraZeneca announced plans to remove Zoladex from the market, risking leaving more than 7,500 women with breast cancer without an alternative treatment.
Both medicines block the release of oestrogen and testosterone and can be used as part of treatment, or for fertility preservation, in some forms of cancer.
The Pharmaceutical Benefits Advisory Committee met urgently in July and recommended making triptorelin unrestricted under the Pharmaceutical Benefits Scheme (PBS), which would mean it was funded for all uses.
The drug has been listed on the PBS for prostate cancer since 2006.
Triptorelin and Zoladex can also be used to treat endometriosis and to block puberty for either precocious puberty or gender-affirming care.
Vicki Durston, director of policy and advocacy at Breast Cancer Network Australia, described the recommendation as “a significant step forward” and said access to the medicine could mean the difference between life and death for some patients.
She said some women had already chosen to have their ovaries removed because of uncertainty over Zoladex supplies.
Marilla Druitt, Victorian state chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said it remained unclear whether triptorelin would work exactly the same way as Zoladex, but the recommendation was likely to be positive for patients with endometriosis and pelvic pain.
She said: “I’m glad we’ve got an alternative.”
“That’s fantastic, and it remains to be seen whether or not it will be as good, but pain is so complex, pain is a really hard thing to study because it’s got so many contributors.”
Druitt said further research would be needed after the medicine was introduced.
If accepted by the federal government, the recommendation would also allow PBS funding of triptorelin for puberty suppression in precocious puberty and gender-affirming care.
This would make gender-affirming care federally funded through the PBS for the first time and would remove a financial barrier for transgender children in Queensland and the Northern Territory.
Stuart Aitken, medical director of Gender Health Australia, said the recommendation had sparked “absolute joy” among his patients.
He said: “It takes away a huge barrier to accessing evidence-based care.”
“It means that the ban has a very limited effect.”
By Women’s HealthX
As healthcare organisations navigate tightening compliance mandates, evolving reimbursement frameworks, and shifting health economics, the single most critical asset for leadership is operational visibility into what their industry counterparts are executing right now.
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Sahar Abid is a Science Associate at Ema EQ, where she works on cultural sensitivity and bias in AI.
A woman asks an AI health assistant about postpartum depression.
She mentions that her in-laws are telling her to “push through” and skip medical help, even as her symptoms get harder to manage. She never says where she is from or names her background.
The assistant describes the condition and gives her a hotline number. It sounds correct, but it misses what she needs.
That gap is more common than the industry admits, and it points to a blind spot in how we test health AI for bias.
Most bias testing looks at what people explicitly say.
The typical way to check an AI for bias is to label a prompt with someone’s demographic details and see if the answer changes. That catches some problems but misses a bigger one.
Most people do not lead with their identity. They lead with their situation. The woman above told the assistant everything it needed to help her, just not in the form of a label.
Her real question was not only “what is postpartum depression?” It was “how do I get care when the people around me don’t want me to?
When family members hold sway over health decisions, and in many communities they do, advice that asks someone to overrule their family is not something they can act on.
The AI didn’t say anything factually wrong. It answered a different question than the one she was living.
We call this culturally implicit bias, meaning the AI misses the cultural context a situation implies rather than the context a person spells out.
When systems are trained to notice only the explicit cues, they fall back on a default answer built for the majority. For everyone else, the response can feel generic, off-target, or discouraging enough that they stop looking for help.
In health, that is not small. The people most likely to be missed are often the ones the system already underserves.
What we set out to test.
At Ema, we wanted to know how well AI picks up on cultural context that is implied but never stated. So we built our own way to test for it, across a range of communities and real situations like postpartum depression and fertility, using questions that carried cultural meaning without announcing it.
The patterns were consistent. Models often missed the meaning underneath the question. They dropped the specific details a person did share and smoothed them into something generic.
And even when they pointed toward real care, they tended to offer one option instead of choices that might actually fit a person’s life. Any one of those can be the difference between someone following the advice and walking away from care.
Why this matters for anyone building health AI.
Getting this right is the right thing to do, and it also works better.
When an answer reflects a person’s real context, people trust and act on the recommendations more, so they get the help and support they need.
Testing for it is harder than the shortcut most teams use. Swapping a name or a demographic label in and out is easy. Checking whether a model actually understands the human context around a question takes more care.
The shortcut teaches models to perform cultural competence instead of practicing it. No matter how much or how little someone chooses to share, they deserve an answer that is warm, complete, and usable.
A better question.
The bar for equitable health AI should be “does it serve someone who never told you who they are?” It is the harder test, but it determines whether real people get help.
The work of getting there is far from finished, and it is exactly what we are building toward at Ema.
Sources: Naidoo, V., & Chadha, K. K. (2025), Culturally responsive AI chatbots: from framework to field evidence, Computers in Human Behavior: Artificial Humans. Souligne, N., & Subbian, V. (2026), FairLogue: A toolkit for intersectional fairness analysis in clinical machine learning models.
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