Objective: To discuss the 18-month follow-up results of fresh ovarian cortical tissue transplant. Design: Case study. Setting: Academic medical center. Patient(s): A 46-year-old patient who was operated on for uterine fibroids, and who then received an ovarian tissue transplant in July 2003. Intervention(s): Serum hormone levels were measured at 3-month intervals. Main Outcome Measure(s): Follicular development evident by ultrasound examination; serum hormone levels (FSH, LH, E2). Result(s): Preoperative and 3rd-, 6th-, 9th-, 12th-, 15th-, and 18th-month hormone levels were, respectively, as follows: FSH: 9.06, 79.5, 13.7, 16.66, 51.91, 44.37, and 24.17 mIU/mL; LH: 5.91, 33.92, 8.78, 21.83, 38.31, 40.85, and 22.4 mIU/mL; E2: 166, 46, 48, 117, 31, 14.4, and 137.7 pg/mL. Folliculogenesis was confirmed by ultrasonography at the 6th, 9th, and 18th months during the follow-up period. Conclusion(s): Fresh ovarian autotransplantation may be a logical alternative for hormonal support for a specific patient group. ©2005 by American Society for Reproductive Medicine.