A woman from Belgium has delivered a healthy baby boy after being transplanted with her frozen ovarian tissue, obtained when she was nearly 14 years old. This brings hope to young girls who are facing infertility issues due to harsh treatments such as chemotherapy or radiation therapy.
The patient was diagnosed with sickle cell anemia when she was five years old. When she was 11, she moved to Belgium, where doctors strongly recommended a bone marrow transplant as her disease became more advanced. Her brother was found to be the perfect match, but before the procedure could be performed, the patient had to undergo a chemotherapy or radiation therapy to reset the immune system and prevent organ rejection. However, chemotherapy and radiation therapy would cause the patient to suffer from lifelong impairment of her ovaries.
The Belgian doctors decided to obtain an ovarian tissue from the patient and froze it. Although the patient had not experienced menarche during that time, indicators such as breast development were apparent, signifying that she was approaching the pubertal stage.
"Children are the patients who are most likely to benefit from the procedure in the future," says Dr. Isabelle Demeestere, study co-author and gynecologist at the Erasmus Hospital at the Free University of Brussels, Belgium. "When they are diagnosed with diseases that require treatment that can destroy ovarian function, freezing ovarian tissue is the only available option for preserving their fertility."
The bone marrow transplant was a success but she had to undergo an immuno-suppressive therapy for 18 months as she was diagnosed with graft-versus-host disease thereafter. She was also given hormone replacement drugs for normal menstruation to ensue after her remaining ovary completely failed when she was 15 years old.
After 10 years, the woman expressed her desire to become pregnant. A team of gynecologists headed by Demeestere deferred the hormone replacement therapy and thawed some of the woman's frozen ovarian tissues. They grafted 11 fragments in different parts of the body and four in the remaining left ovary.
The tissues responded well to her hormones and soon enough, she generated follicles that consisted of maturing eggs. After five months, the woman started to have regular menstrual cycles. She did not get pregnant at once as her partner was found to be infertile.
Two years later, she had a new partner and finally conceived a child. At 27 years old, the woman who was severely sick and underwent multiple medical procedures as a child, gave birth to a healthy baby boy, who weighed 6.9 pounds.
"This was like a victory for her; she was so happy after living with that uncertainty for years," Demeestere says.
Professor Simon Fishel, president of the CARE fertility group, thinks this case is particularly vital and showcases how the future of human reproduction would be.
"It is not the first success using cryo-preserved ovarian tissue, but it is the first of its kind in relation to the case history," he says. "It further supports the need for the acceptance and wider development of ovarian tissue frozen storage and potential use in the future—either for fertility preservation or, indeed, a potential replacement of medication used post-menopausally."
Photo: Ed Uthman | Flickr
