Pioneering ovarian tissue graft helps cancer survivor become pregnant
Dr Daniel Grimes
Progress Educational Trust11 September 2013
A woman in Australia has become pregnant with her own eggs following an ovarian tissue transplant seven years after her ovaries were removed during cancer treatment.
In a world first, the woman's ovarian tissue, which had been cryopreserved, was grafted onto her abdominal wall where it began to produce eggs. The eggs were then removed, fertilised, and transplanted back into her uterus.
'The tissue was put back in the front wall of her abdomen, so that means it's under the skin and the muscle but not inside the abdomen', said Dr Kate Stern, the patient's fertility specialist who worked as part of a team at Melbourne IVF and The Royal Women's Hospital in Victoria.
'We wanted to see if this might help her get pregnant. Then we gave her some very gentle hormone stimulation – not the full-on IVF', Dr Stern added.
The pregnancy indicates that with the right blood supply and stimulating hormones, ovarian tissue can still produce eggs even when it is grafted away from its original position in the pelvis, known as orthotopic transplantation.
Professor Gab Kovacs of Monash IVF said he would recommend storing ovarian tissue to women with conditions such as ovarian cancer, where the treatment could make them infertile. 'It makes me quite convinced that the optimal way of preserving fertility will be taking ovarian tissue', he told The Sunday Morning Herald.
The Royal Women's Hospital is now developing an initiative to collect and freeze ovarian samples from young woman that might become infertile due to cancer treatment.
It is hoped that the new procedure can be offered to patients with severe pelvic disease, where the ovarian tissue cannot be put back into the pelvis. 'We can now offer these patients a realistic chance of getting pregnant', Dr Stern told The Sunday Morning Herald.
The patient, known as Vali, who is pregnant with twins, is now the first person in the world to become pregnant with eggs produced from ovarian tissue transplanted into her abdomen. She told ABC News that she was lucky to 'have the opportunity to freeze tissue [in the] hope that someday, something would be possible'.
There have been 29 births worldwide from stored ovarian tissue that was later transplanted back into or near to the original position, but the success rate is low.
Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.