For the first time, a woman has given birth after surgeons implanted ovarian tissue that had been removed when she was a child. Several babies have been born from tissue taken from adult women, but this is the first success with tissue removed before puberty, reported the doctors in Human Reproduction.
Isabelle Demeestere at Erasmus Hospital at Brussels Free University, whose team carried out the transplant, 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."
The girl, born in the Republic of Congo, was diagnosed with sickle-cell anemia, a genetic blood disorder, when she was five-years-old. After she emigrated to Belgium at the age of 11 years, doctors found the disease was so severe that she needed a bone marrow transplant. The procedure required chemotherapy or radiotherapy to disable the immune system so that it does not to reject the transplanted marrow. Since there was a possibility of ovary damage due to the therapy, her right ovary was removed and frozen in fragments in the hope that it could be used if she ever wanted to become a mother.
Demeestere said, "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." The transplant was successful, although the girl had to continue with immuno-suppressive drugs for a further 18 months, and her left ovary failed.
A decade later, when the women wanted to have a family, surgeons in Belgium grafted four ovarian fragments to the remaining left ovary and 11 fragments at other sites. The patient started menstruating regularly five months later. More than two years after the transplantation, the woman became pregnant naturally and a baby boy was born November, 2014.
The patient's ovary continues to function normally, while she also has the remaining fragments in storage.