Israeli breakthrough – Frozen ovarian tissue transplant reverses infertility

Offering hope to the millions of younger women who face losing their fertility after chemotherapy, Israeli doctors have succeeded in reversing infertility caused by cancer treatment. The New England Journal of Medicine reported that a 28-year-old woman gave birth Monday …

Offering hope to the millions of younger women who face losing their fertility after chemotherapy, Israeli doctors have succeeded in reversing infertility caused by cancer treatment.

The New England Journal of Medicine reported that a 28-year-old woman gave birth Monday to a healthy baby girl after an ovarian tissue transplant performed by Dr. Dror Meirow and Prof. Shuki Dor of Sheba Medical Center in Tel Aviv reversed infertility caused by the woman’s previous treatment for non-Hodgkin’s lymphoma.

This appears to be the first time scientists have managed to preserve fertility by freezing ovarian tissue and then transplanting it in humans, the researchers said. The method could become an accepted solution for cancer-stricken women who want to give birth, if additional experiments prove the method to be effective.

Details of the procedure will appear in the July 21 issue of the New England Journal of Medicine, but were released Monday to coincide with the birth of the baby at Sheba.

The Israeli woman highlighted in the report initially underwent two unsuccessful courses of conventional chemotherapy for non-Hodgkin’s lymphoma. Before attempting a high-dose regimen, she asked that ovarian tissue be removed and frozen.

“I wasn’t so keen about it because she had already had two chemotherapy courses, but she persisted,” study senior author Dr. Jehoshua Dor, director of the In Vitro Fertilization (IVF) Center at Sheba, told Red Nova.

Two years later, after she had recovered from the lymphoma, lab tests showed she remained infertile. Strips of her frozen tissue were attached to her left ovary and fragments of it were injected into the right one.

“We waited because we wanted to see that she was healthy, and until she felt more secure that the disease won’t return,” Me’irov told Ha’aretz.

Nine months later she had resumed having periods. A single egg was retrieved from the left ovary, fertilized with her husband’s sperm in a lab dish, and the pregnancy resulted from the resulting embryo.

“Although we cannot rule out the possibility that this egg was derived from the native ovary, we consider this possibility very unlikely” because of the timing of pregnancy and tests consistently showing the woman had been infertile before that, the doctors write.

Last year, a Belgian woman gave birth after such an operation, but the claim was controversial because the egg could have come from her remaining ovary, not the transplanted tissue. The Sheba transplant is more convincing because menopause was documented for two years before the transplant.

The baby girl weighing 6.6 pounds was delivered by Caesarean section. Meirow said the mother and baby were doing well. “The baby weighed three kilos at birth,” Meirow said. “She was examined by a pediatrician, and she is healthy. Both mother and daughter are feeling just fine.”

Dor attributed the success to transplanting the tissue into the ovaries themselves.

“I thought that transplantation should be done in the ovary itself, not under the skin, not in the abdominal wall, not under the skin of the arm,” he told Red Nova. “People were scared that the ovaries following chemo were damaged. This is correct, but the follicles are damaged, not the blood supply. The blood supply is good enough to allow the implants to develop and to function.”

The Israeli team think the techniques they used may also be able to help preserve fertility in older women.

“I’m very curious what will be the ovarian function [in the 28-year-old woman] from now. Will it keep on going?” said Dor. “If yes, then it can also be a sort of a therapy to postpone menopause in the future. Maybe we can use it also in benign situations like severe endometriosis. I think there are a lot of possibilities. But, meanwhile, we should be careful and look at the first cases and learn more about it,” Dor added.

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