A woman who had her ovarian tissue removed and frozen following a childhood illness has made history by giving birth after having her fertility restored by doctors.
The medical landmark is expected to give hope to seriously ill young women and girls who fear chemotherapy might hinder their chances of conceiving.
The young mother, who has not been named to protect her identity, underwent the life-saving surgery to remove her right ovary when she was just 13 having been diagnosed with sickle-cell anaemia which required chemotherapy.
She was born in Congo but had moved to Belgium by the age of 11, where she underwent the operation.
A decade later, doctors began to examine ways of restoring the woman’s fertility after the patient told counsellors she wished to become a mother.
Medics led by Isabelle Demeestere, a gynaecologist at Erasme Hospital in Brussels, stopped the patient’s hormone replacement therapy, thawed some of the frozen ovarian tissue and grafted four fragments on to the remaining left ovary, and 11 other fragments at other sites in the body.
The transplanted tissue started to respond to her hormones and successfully growing follicles that contained the maturing eggs. The patient started menstruating within five months.
However, the patient only became pregnant two years later – at the age of 27 – after she discovered her previous boyfriend was infertile and started a new relationship.
She delivered a healthy boy in November 2014, weighing just under 3.1 kilos.
The details have been released in the Human Reproduction journal.
Demeestere said: “This is an important breakthrough in the field because children are the patients who are most likely to benefit from the procedure in the future. When they are diagnosed with diseases that require treatment that can destroy ovarian function, freezing ovarian tissue is the only available option for preserving their fertility.
“However, the success of this procedure requires further investigation in very young, prepubertal girls, as our patient had already started puberty even although she had not started menstruating. In addition, the procedure also raises some controversial issues.”
The patient’s ovary continues to function normally and her doctors say there is no reason why she could not have more babies if she wants to.
Adam Balen, from the Leeds Centre for Reproductive Medicine, said: “There had previously been uncertainty as to whether ovarian tissue taken from young girls would later on be competent to produce mature, fertile eggs, so today’s case is both reassuring and exciting.
“We have to remember that many children who require chemotherapy are very ill and the surgery to remove ovarian tissue is no small undertaking. Furthermore there are only a few centres where the technology is available and this sort of treatment achievable.”
About the treatment
■ Ovarian tissue freezing is an experimental procedure used in humans since the mid-1990s.
■ This technique may be an option for women whose oncologist recommends they don’t use hormone stimulation or are unable to delay treatment to begin hormonal stimulation, for women who have moral or ethical issues with egg and embryo freezing and for teens as well as prepubescent girls.
■ It may not be a viable option for women whose cancer has spread to the ovaries or who carry the breast cancer genetic mutation. To date, 15 babies have been born worldwide from ovarian tissue freezing. The promise of this technique could prove to be revolutionary for cancer patients.
■ Doctors remove part or all of an ovary in a one-hour outpatient surgical procedure. The tissue that is removed is divided into thin strips, each of which contains hormone-producing cells and immature eggs. The tissue is then frozen and stored for future use.