Live birth after orthotopic grafting of autologous cryopreserved ovarian tissue and spontaneous conception in Italy

Capsule:
A live birth was obtained after frozen/thawed ovarian tissue autologous transplantation in a patient with precocious ovarian failure after chemotherapy and bone marrow transplantation.

Authors:
Alberto Revelli, M.D., Ph.D., Gianluigi Marchino, M.D., Elisabetta Dolfin, M.D., Emanuela Molinari, M.S.C., Ph.D., Luisa Delle Piane, M.D., Francesca Salvagno, M.D., Chiara Benedetto, M.D., Ph.D.

Volume 99, Issue 1, Pages 227-230, January 2013

Abstract:

Objective:
To describe the live birth obtained in Italy after autologous orthotopic transplantation of cryopreserved ovarian cortical tissue.

Design:
Case report.

Setting:
University department of gynecology and obstetrics, reproductive medicine and IVF unit.

Patient:
A 29-year-old patient affected by beta-thalassemia (intermedia phenotype) who underwent chemotherapy and bone marrow transplantation at age 21 resulting in a complete precocious ovarian failure (POF).

Interventions:
Before being treated with chemotherapy (busulfan, cyclophospamide, and cyclosporine) for bone marrow transplantation, the patient underwent laparoscopic sampling of ovarian cortical tissue that was frozen and cryopreserved in liquid nitrogen. Eight years later, the ovarian tissue was thawed and grafted during laparoscopy at an orthotopic site.

Main Outcome Measures:
Ultrasound and endocrine monitoring of the post-grafting restoration of ovarian function; conception, pregnancy, and live birth

Results:
Three months after grafting, the decrease of circulating FSH levels and the parallel increase of estradiol levels witnessed ovarian function restoration, which was confirmed by ultrasound bi-dimensional and colour Doppler examinations. After some ovulatory cycles, the patient spontaneously conceived 16 months after transplantation. After 39 weeks of uneventful gestation, a healthy girl weighting 3,970 g was born.

Conclusions:
Autologous grafting of cryopreserved ovarian cortex at the orthotopic site may allow ovarian function restoration, spontaneous conception, and birth of an healthy baby.

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