First Pregnancy From Ovarian Tissue Grafted in the Anterior Abdominal Wall
Virtus Health's world leading fertility preservation team, led by Associate Professor Kate Stern, Head of Fertility Preservation at Melbourne IVF and the Royal Women’s Hospital announced the world’s first pregnancy from ovarian tissue grafted in the anterior abdominal wall of a Victorian woman.
The Melbourne woman, Vali, sought the tissue preservation treatment to help save her fertility after the loss of ovarian function through cancer treatment.
Prior to surgery to remove her second ovary at the age of 23, she requested the ovarian tissue be frozen.
Seven years after the cancer treatment that left her menopausal, Vali asked for the frozen ovarian tissue to be thawed and grafted back to help her conceive a baby with her own eggs.
Freezing and transplantation of ovarian tissue back into the original position in the pelvis, known as orthotopic transplantation, has resulted in 29 births world-wide.
However, heterotopic transplantation – where ovarian fragments are grafted at alternative sites distant from their physiological location, including the abdomen and breast – has until now not resulted in a clinical pregnancy.
With the supply of blood and stimulating hormones to increase the viability of the transplanted tissue, follicle development can occur and mature eggs can be retrieved from the heterotopic site. Once harvested, IVF can be employed.
Vali, who had the ovarian tissue grafted to the anterior wall of her abdomen, is now 25 weeks into her pregnancy and is expecting twins.
The pioneering procedure, reported at the annual scientific meeting of the Fertility Society of Australia in Sydney on Monday, 2nd September, is a triumph for a team of fertility specialists at Melbourne IVF, led by its Head of Fertility Preservation, Associate Professor Kate Stern, and the Royal Women’s Hospital.
The team included:
- Dr Lyndon Hale, Medical Director Melbourne IVF, who led the surgical procedure;
- Dr Debra Gook, the scientist who developed the laboratory processes for the freezing and thawing of ovarian tissue;
- Associate Professor John McBain, AO who heads the Reproductive Services at the Women’s; and
- Researchers, scientists and nurses who are all intensively involved in the Fertility Preservation program.
- Associate Professor Stern, who is also head of the Medical Preservation of Fertility Special Interest Group of the Fertility Society, said improvements in cancer therapy had resulted in long-term survival from many malignancies.
However, a significant proportion of patients are left infertile because of the toxic effects of some cancer treatments, or because of the surgical removal of their reproductive organs.
Associate Professor Stern said Vali and her partner, Dean had received extensive counselling about the risk of tumor cell transmission through the grafting procedure, but comprehensive and repeated tests in association with her oncologist had shown no evidence of this occurring.
“This is the first demonstration of an on-going pregnancy from a heterotopic graft site and it provides renewed optimism for women who are facing ovarian surgery or radiotherapy to treat cancer.
“There is no doubt the eggs have come from the transplanted tissue on the abdominal wall.
“Most importantly, this pregnancy provides unequivocal evidence that cryopreservation, or freezing of the ovarian tissue, preserves follicle development and that normal ovarian function and pregnancy can occur at a non-ovarian site.
“We are now introducing a new program for retrieval and transport of ovarian tissue from other centres for cryopreservation and storage in our centre.
“This will allow patients being treated outside the major centres to have the optimal opportunity for cryopreservation of their precious ovarian tissue.”