Ovary transplanted to arm stays functional

Dr. Kirsty Horsey

Progress Educational Trust

08 November 2004

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[BioNews, London] Doctors at Leiden University Hospital in the Netherlands have announced success in fertility preservation. They have successfully transplanted a woman's whole ovary into her arm in order to save her fertility while she undergoes cancer treatment. The operation took place two years ago but the details are only just about to be published, in the December edition of the journal Cancer.

The woman, who was 29 years old, had cervical cancer. While surgery for cervical cancer can improve the chance of survival, it can also cause early and permanent ovarian failure. In an attempt to prevent this, doctors removed one of the woman's ovaries while carrying out surgery for the cancer, and transplanted it to her left upper arm. The arm is thought to be a good place for transplants of this sort, as it allows the ovary to be kept intact and keeps it well supplied with blood. In this case, the ovary retained its function and ovulated every month ? the eggs were absorbed into the surrounding tissue. If the woman had wanted to have children, IVF procedures could have been used to harvest eggs from the ovary. Unfortunately, the woman's cancer returned, and she died recently.

The procedure will add to the growing list of techniques used to try and preserve the fertility of women when they undergo cancer treatment. This transplant would not work if the woman were undergoing chemotherapy, however, but the principles involved in the procedure show that it may be feasible to remove intact ovaries from women before they begin treatment and transplant them back to the arm when it is finished.

Recently, Belgian doctors reported a successful pregnancy using slivers of ovary that had been removed from a woman before cancer treatment and frozen, then thawed and grafted back into her when her health recovered. This produced the first birth using this technique. Previously some women had been able to restore their menstrual cycle, but none had succeeded in becoming pregnant. 'This is a very powerful new procedure', said Dr Carina Hilders, a member of the team which carried out the latest study. She added: 'It is the first time anyone has successfully transplanted an entire ovary into another part of the body and preserved its functions'.

Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.