Perioperative safety of emergency ovarian tissue cryopreservation for fertility preservation in hematological patients prior to hematopoietic stem cell transplantation

OBJECTIVE: Hematological patients constitute a key group for fertility preservation, but the surgical risk of emergency ovarian tissue cryopreservation (OTC) before hematopoietic stem cell transplantation (HSCT) is unclear. This study investigates the perioperative safety of emergency OTC management in hematological patients prior to HSCT, and explores the correlation between perioperative treatment, surgical complications, and disease type. Design a single-center retrospective study. METHODS: A single-center retrospective analysis was conducted on 67 hematologic patients (non-neoplastic: aplastic anemia, Fanconi anemia, thalassemia; neoplastic: myelodysplastic syndromes, acute lymphocytic leukemia, acute mixed leukemia, acute myeloid leukemia, lymphoma) who underwent emergency OTC before HSCT (January 2023-December 2025). Perioperative management and complications were analyzed, with logistic regression employed to assess the correlation between hematological disease type and perioperative complication occurrence. RESULTS: Compared with the neoplastic group, the non-neoplastic group had a significantly higher incidence of mild infections (21.43% vs. 0%; p < 0.05). No significant differences were observed in perioperative bleeding (5 vs. 10, p = 0.319) or prolonged hospitalization (5 vs. 6, p = 0.925), both of which were infrequent. The non-neoplastic group also showed significantly lower perioperative blood counts (p < 0.05). Accordingly, these patients required more hematologic support during the perioperative period, with higher rates of red blood cell transfusion (80.95% vs. 28.00%; p < 0.01) and platelet transfusion (90.48% vs. 12.00%; p < 0.01). Logistic regression confirmed a strong association between non-neoplastic hematologic disorders and the need for perioperative red blood cell and platelet transfusion but showed no link with hospitalization duration (p = 0.296). CONCLUSION: With active perioperative management, patients undergoing emergency OTC prior to HSCT had a low incidence of adverse outcomes. Nevertheless, perioperative care for non-neoplastic patients warrants increased attention.