Ovarian transplant produces baby
Healthy birth raises hope for cancer patients' fertility.
Belgian doctors say they have achieved a first in infertility treatment: they enabled a woman to give birth to a baby after her ovarian tissue was frozen for seven years and then grafted back into her body. But other experts question whether they have really achieved all they claim.
The new mother, Ouarda Touirat, is a 32-year-old Belgian who developed Hodgkin's lymphoma seven years ago. Before her chemotherapy and radiation treatment, which damaged her ovaries, doctors removed and froze samples of her ovarian tissue.
Last year, thawed pieces of her ovarian tissue were reintroduced below one of her remaining, non-functioning ovaries.
Five months later she began to ovulate, and six months after that, she became pregnant naturally. News of her pregnancy was revealed at the European Society for Human Reproduction and Fertility Conference in Berlin earlier this year (see " Frozen ovary restores fertility").
The healthy, 3.72-kilogram baby, called Tamara, was born yesterday at the Cliniques Universitaires Saint-Luc in Brussels, Belgium. A team led by Jacques Donnez of the Catholic University of Louvain in Brussels reports the birth in a paper published online by The Lancet1. "The mother and baby are in excellent health," a hospital spokeswoman says.
However fertility expert Kutluk Oktay, of Weill Medical College of Cornell University, New York, questions the researchers’ claim. He believes the pregnancy could have resulted if one of the woman's ovaries survived the chemotherapy and produced eggs on its own.
He points out that few women who have chemotherapy for Hodgkin's lymphoma, as this woman did, are completely sterilised by the treatment. "Maybe we should have an apple cider this time and save the Dom Perignon for next time," he says.
In March this year, Oktay reported that he had created an embryo for a breast cancer patient in his clinic, whose ovarian tissue had been frozen for six years and grafted onto her stomach. In this case, the egg was collected from the graft and fertilised in a dish by in vitro fertilization (IVF). But when the embryo was implanted in the woman, it did not survive.
In the paper, Donnez's team lists a series of arguments saying why they believe the pregnancy resulted from the transplanted tissue. For example, the researchers say that they observed a developing egg in the graft, but none in the two ovaries, just before the woman fell pregnant.
Whether or not the newborn really is a fertility first, Oktay is hopeful that the technique will work with some perseverance. If so, the technique could benefit thousands of women who are unable to have a family naturally after cancer treatments.
"Ovarian tissue cryopreservation should be an option offered to all young women diagnosed with cancer, in conjunction with other existing options for fertility preservation," says Donnez.
But the technique could also, in theory, be used by those who wish to delay having children until after the menopause. Women are born with around a million eggs, which slowly die off as they age. Some might choose to have samples of their ovaries preserved and then re-implanted after their natural fertility has dwindled.
But reproductive biologist Richard Anderson from the University of Edinburgh, warns that the procedure involves invasive surgery, and could be dangerous for the woman. "This would not be advised," he says.
- Donnez J., et al. The Lancet, published online http://www.thelancet.com September 24 (2004).