Kutluk Oktay1, Ilgın Türkçüoğlu, Kenny A Rodriguez-Wallberg. 1. Department of Obstetrics and Gynecology, Institute for Fertility Preservation, New York Medical College-Westchester Medical Center, Valhalla, New York 10595, USA. koktay@fertilitypreservation.org
Abstract
OBJECTIVE: To report the long-term follow-up of an experimental heterotopic ovarian transplantation with frozen-thawed ovarian tissue. DESIGN: Long-term follow-up of an experimental surgery; case report. SETTING: Academic reproductive medicine center. PATIENT(S): A 28-year-old cancer survivor with previous Hodgkin disease and relapse. INTERVENTION(S): Laparoscopic oophorectomy for ovarian cryopreservation before preconditioning chemotherapy for hematologic stem cell transplantation. Ovarian tissue thawing and subcutaneous heterotopic ovarian transplantation in the lower abdominal wall 2½ years after the hematologic stem cell transplantation. MAIN OUTCOME MEASURE(S): Resumption of ovarian function after transplantation, recovery of fertility, and pregnancy outcome. RESULT(S): Follicle development was observed in the graft 2 months after transplantation, and a P value of 14 ng/mL indicated ovulation. The patient conceived spontaneously four times within 5 years and delivered three children. The in situ ovary remained atrophic but showed occasional follicle activity contemporaneously with the graft. CONCLUSION(S): The mechanism behind spontaneous restoration of fertility with consecutive viable pregnancies after a heterotopic ovarian transplantation needs to be explored. Further laboratory and clinical research will be needed to explore the true origin of pregnancies after ovarian transplantations.
OBJECTIVE: To report the long-term follow-up of an experimental heterotopic ovarian transplantation with frozen-thawed ovarian tissue. DESIGN: Long-term follow-up of an experimental surgery; case report. SETTING: Academic reproductive medicine center. PATIENT(S): A 28-year-old cancer survivor with previous Hodgkin disease and relapse. INTERVENTION(S): Laparoscopic oophorectomy for ovarian cryopreservation before preconditioning chemotherapy for hematologic stem cell transplantation. Ovarian tissue thawing and subcutaneous heterotopic ovarian transplantation in the lower abdominal wall 2½ years after the hematologic stem cell transplantation. MAIN OUTCOME MEASURE(S): Resumption of ovarian function after transplantation, recovery of fertility, and pregnancy outcome. RESULT(S): Follicle development was observed in the graft 2 months after transplantation, and a P value of 14 ng/mL indicated ovulation. The patient conceived spontaneously four times within 5 years and delivered three children. The in situ ovary remained atrophic but showed occasional follicle activity contemporaneously with the graft. CONCLUSION(S): The mechanism behind spontaneous restoration of fertility with consecutive viable pregnancies after a heterotopic ovarian transplantation needs to be explored. Further laboratory and clinical research will be needed to explore the true origin of pregnancies after ovarian transplantations.
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