First reported clinical pregnancy following heterotopic grafting of cryopreserved ovarian tissue in a woman after a bilateral oophorectomy

Abstract

Ovarian tissue cryopreservation and transplantation is a form of fertility preservation offered to young women at high risk of losing ovarian function after cancer treatment. While there have been successful births resulting from orthotopic site grafts, we report the first case of an ongoing pregnancy from a heterotopic graft in a patient who had previously undergone bilateral oopherectomy for a granulosa cell tumour. Frozen-thawed ovarian tissue was transplanted to the anterior abdominal wall. Subsequent ovarian stimulation and transabdominal ultrasound-guided oocyte retrieval from the grafts resulted in two oocytes. These were fertilized with ICSI and two embryos were transferred. Serial ultrasounds have confirmed an ongoing 26-week intrauterine twin pregnancy. Thus, this first demonstration of a pregnancy from a heterotopic graft site provides unequivocal evidence that cryopreservation preserves complete follicle development and that normal ovarian function can occur at a non-ovarian site. This provides optimism for further efforts to assist women who have had oophorectomy and pelvic surgery or radiotherapy, without an appropriate orthotopic site for grafting.

86 successful births and 9 ongoing pregnancies worldwide in women transplanted with frozen-thawed ovarian tissue: focus on birth and perinatal outcome in 40 of these children

“…3/child no. 35 The woman was 31 years old when she in 2009 was diagnosed with aplastic anemia during her first pregnancy. It was decided to perform a caesarean section at GA 33+ in order to start NC naturally conceived, IVF in vitro fertilization, IUI intrauterine insemination, CS caesarean section, VD vaginal delivery, NS not specified a The GA on 3 singleton births is not available immunosuppressive treatment and anti-thymocyte globulin (ATG).…”

Alginate encapsulation supports the growth and differentiation of human primordial follicles within ovarian cortical tissue

“…Ovarian tissue removal, cryopreservation, and later transplantation back into an individual has successfully restored both fertility and endocrine function [14][15][16]. In fact, autologous transplantations of thawed ovarian cortical tissue have resulted in 17 reported live births [17][18][19][20][21][22][23][24][25][26][27][28][29][30]. However, the data surrounding ovarian transplantation is controversial because typically only positive outcomes are reported, thus obscuring the success rate.…”

Cancer treatment and gonadal function: experimental and established strategies for fertility preservation in children and young adults

“…Successful pregnancy has recently been reported following transplantation of ovarian tissue to a site outside the pelvis, i.e. to the anterior abdominal wall 108 , although such heterotopic transplantation has previously been less successful than replacement within the pelvis. The success rate, i.e.…”