New Ovarian Transplant Surgical Procedure Gives Fertility Hope to Cancer Survivors

An advancement in the surgical procedure for ovarian transplants gives new fertility hope to cancer survivors. A new two-step ovarian transplant surgical procedure that increases the chance of fertility after cancer treatment was outlined by Dr. Pascal Piver at the 25th annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) on June 29, 2009.

Speaking of this new ovarian transplant surgical procedure, Dr. Piver said, "We hope that it will enable more young patients who have been cured of cancer to regain their reproductive health and become pregnant with their own children."

Infertility Concerns For Cancer Survivors

The toxic drugs used in chemotherapy frequently leaves cancer survivors infertile. One infertility solution for young female cancer patients is to have ovarian transplants using their own ovaries. The ovarian transplant procedure involves removing one or both ovaries before chemotherapy begins, freezing them, then reimplanting the tissue once the cancer treatment is successful.

In the past, ovarian transplants have had a low success rate, with only a few resulting in natural pregnancy. This is because it is difficult to regain the functionality of the ovary after transplantation, primarily due to amount of time it takes the body time to re-establish a full blood supply to the organ.

Dr. Pascal Piver, who manages the IVF (in vitro fertilization) Centre at Limoges University Hospital, Limoges, France, explained, "In order for a woman to become pregnant, the ovaries need to be responsive to the action of hormones that cause them to release eggs each month. If the blood supply to the ovaries is insufficient, this will not happen, even though the transplant may look as though it has been successful."

A Step Forward in Ovarian Transplant Surgical Procedures

To overcome the blood supply problem in ovarian transplants, Dr. Piver and his team developed a two-step ovarian transplant surgical procedure using ovarian tissue grafts to encourage blood vessel growth before the ovarian transplant occurs. Ten tiny pieces of frozen ovarian tissue are grafted into the ovarian and peritoneal (the lining of the abdominal cavity) areas three days before the actual ovarian transplant is performed. Using the grafts to encourage blood vessel growth before the ovarian transplant allows the ovaries to become fully functional in a shorter amount of time than the standard technique of reimplanting all the tissue at once.

Success Already Seen With New Ovarian Transplant Surgical Procedure

Dr. Piver and his team have already seen remarkable results using this new ovarian transplant technique, with one woman from their clinic delivering a healthy baby girl after becoming pregnant without the use of in vitro fertilization.

"On June 22, a baby girl was born to a mother who had been menopausal for two years as a result of treatment for sickle cell anemia. After transplanting her own ovarian tissue she started ovulating in four months and became pregnant naturally six months after transplantation. Both mother and baby are doing well," announced Dr. Piver.

A second woman in his clinic, who has been receiving treatment for periarteritis nodosa (a blood vessel disease that requires the use of immune-suppressing medication) has also become pregnant.

"She suffered menopause for eight and a half years before transplantation," explained Dr. Piver. "But after transplanting half of the frozen ovary, she recovered spontaneous ovulation in four months."

Dr. Piver expressed his excitement, "This is the first time that a pregnancy has been obtained after a ten year gap between ovarian cryopreservation and grafting. We believe that it represents a considerable advance on the methods of ovarian transplantation used until now."