Journal
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
Volume 94, Issue 3, Pages 324-328Publisher
WILEY
DOI: 10.1111/aogs.12568
Keywords
Cancer; chemotherapy; fertility preservation; iatrogenic ovarian failure; live birth; ovarian tissue cryopreservation; ovarian transplantation; pregnancy; survivorship; uterine irradiation
Categories
Funding
- Swedish Research Council
- Swedish Society for Medical Research (SSMF)
- Swedish Society of Medicine
- Stockholm County Council
- Karolinska Institutet
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We report the first successful transplantation of cryopreserved ovarian cortical tissue into heavily irradiated tissues in a patient who had received sterilizing pelvic radiotherapy (54Gy) and 40weeks of intensive high-dose chemotherapy for the treatment of Ewing's sarcoma 14years earlier. Repeated transplantation procedures were required to obtain fully functional follicular development. Enlargement of the transplants over time and increase of the size of the uterus were demonstrated on sequential ultrasonographic examinations. Eggs of good quality that could be fertilized in vitro were obtained only after a substantial incremental increase of the amount of ovarian tissue transplanted. Single embryo replacement resulted in a normal pregnancy and the birth of a healthy child by cesarean section at full-term. No neonatal or maternal postoperative complications occurred. Women facing high-dose pelvic radiotherapy should not be systematically excluded from fertility preservation options, as is currently the trend.
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