New Ovarian Transplant Technique Could Preserve Fertility in Cancer Patients

A new two-step method for ovarian transplant has shown excellent results in women whose ovaries had been frozen due to cancer treatment.

Researchers at Limoges University Hospital (France) divided the transplant process into two separate procedures. They first grafted small pieces of the frozen ovarian tissue in the ovarian and peritoneal areas three days before the actual organ transplant; this encouraged the growth of blood vessels, and paved the way for the actual transplant. By the two-step process, the ovary was able to become fully functional in a shorter time scale than would be possible if all the tissue were to be transplanted at the same time. The researchers have so far utilized the new technique in two patients who had been treated for cancer and had their ovaries frozen. The first patient had been menopausal for two years, as a result of treatment for sickle cell anemia. After transplanting her own ovarian tissue, she started ovulating four months later. She became pregnant naturally six months after transplantation, and gave birth during June 2009.

The second patient had been treated for periarteritis nodosa, an inflammation of medium-sized arteries, which become swollen and damaged from attack by rogue immune cells. She suffered menopause for eight and a half years before transplantation, but after transplanting half of the frozen ovary, she recovered spontaneous ovulation in four months. Since her right fallopian tube had been destroyed by the ovarian retrieval, the researchers decided to collect the highest number of eggs they could, and carried out an in vitro fertilization (IVF) procedure on the patient. Six months after the operation, the researchers transferred two blastocysts to the patient, who unfortunately developed an ectopic pregnancy; however, she is now pregnant again. The study was presented at the annual meeting of the European Society of Human Reproduction and Embryology, held during June-July 2009 in Amsterdam (The Netherlands).

"This is the first time that a pregnancy has been obtained after a ten year gap between ovarian cryopreservation and grafting. We believe that it represents a considerable advance on the methods of ovarian transplantation used until now, not least because we are able to obtain large numbers of oocytes,” said lead author and study presenter Pascal Piver, M.D., manager of the IVF Centre at Limoges University Hospital. "We hope that it will enable more young patients who have been cured of cancer to regain their reproductive health and become pregnant with their own children.”

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Limoges University Hospital