Live birth after transplantation of frozen-thawed ovarian tissue after bilateral oophorectomy for benign disease

Capsule:
Ovarian function was restored and pregnancy achieved in a woman who had previously undergone bilateral oophorectomy for benign disease and in whom frozen-thawed ovarian cortex was subsequently autotransplanted.

Authors:
Jacques Donnez, M.D., Ph.D., Pascale Jadoul, M.D., Céline Pirard, M.D., Ph.D., Graham Hutchings, M.D., Ph.D., Dominique Demylle, Ph.D., Jean Squifflet, M.D., Ph.D., Johan Smitz, M.D., Ph.D., Marie-Madeleine Dolmans, M.D., Ph.D.

Volume 98, Issue 3, Pages 720-725, September 2012

Abstract:

Objective:
To report restoration of ovarian function and pregnancy in a woman after bilateral oophorectomy for benign disease following autotransplantation of cryopreserved ovarian cortex.

Design:
Case report.

Setting:
Gynecology research unit in a university hospital.

Patient:
A 28-year-old woman who underwent bilateral adnexectomy for ovarian abscesses at the age of 18 years.

Intervention(s):
We performed ovarian cortex autotransplantation to a peritoneal pocket in the broad ligament.

Main Outcome Measure(s):
Restoration of ovarian activity and pregnancy.

Result(s):
Restoration of ovarian function began at 20 weeks and was achieved 24 weeks after transplantation. After the fifth stimulation attempt, 2 mature oocytes were obtained and microinjected. One embryo (7 cells) was obtained and transferred, leading to a normal pregnancy. The patient delivered a healthy baby boy weighing 2370g at 38 weeks of gestation.

Conclusion(s):
Ovarian cortex cryopreservation can be performed at the time of surgery for benign diseases when fertility is impaired. We report the first pregnancy to occur after ovarian tissue cryopreservation for benign ovarian pathology following bilateral oophorectomy.

  • Ana Cobo

    Congratulations
    for this exiting report. The authors have demonstrated that pregnancies and live birth are possible after grafting of ovarian cortex after bilateral oophorectomy. This remarkable report excludes the possibility of other pregnancies reported to be originated from any remaining ovary and confirms that viable MII oocytes, able to produce ongoing pregnancies and live births, can be recovered from the transplanted tissue. However as authors have experienced with this case, the MII oocytes recovery is not as efficient as expected. A possible strategy to increase IVF outcomes would be to accumulate oocytes from several COS cycles. Those viable MII oocytes cold be vitrified to build up a larger cohort with higher probabilities of success. We have a great experience applying this strategy to low responder patients and the case healthy twins born after several cycles of vitrification of MII oocytes achieved after grafting of ovarian cortex (SF cryopreserved) published by Sanchez et al is a good evidence of the scope of this strategy.

Translate »