Woman Has Successful Ovary Transplant to Arm
Procedure Offers Promise for Preserving Fertility Following Cancer Treatment
Nov. 8, 2004 -- It sounds a little like science fiction, but researchers in the Netherlands report that they were able to preserve fertility in a 29-year-old cervical cancer patient by removing her ovary prior to treatment and placing it inside her upper arm.
Investigators say the transplantation technique is a promising option for preventing infertility among women in their childbearing years undergoing pelvic radiation for cancer.
The transplanted ovary has continued to produce hormones in its new location in the two years since the surgery was performed. But the patient has not yet attempted to have a child because of a return of her cancer last year.
If pregnancy were attempted, it would be through in vitro fertilization. Eggs would be retrieved from the transplanted ovary in the arm.
"The upper arm is a very suitable place for [egg] retrieval because it is easy to get to," lead researcher Carina G. Hilders, MD, PhD, tells WebMD.
Infertility Common After Treatment
As many as 50,000 women in their childbearing years are diagnosed with cancer each year in the U.S. With more and more of them surviving, preserving fertility following cancer treatment has become a major area of research. Chemotherapy, radiation, and surgery often bring on premature menopause, and the options for preserving fertility are few.
In September, researchers in Belgium reported the first live birth from frozen ovarian tissue. The tissue had been removed from the woman and banked seven years earlier, before she underwent chemotherapy for Hodgkin's disease.
Ovarian transplantation is not appropriate for women treated with chemotherapy, but it may be a better option than the ovarian freezing and thawing technique for those who have pelvic radiation, Hilders says. That is because damage to egg-containing follicles in ovaries is minimal with transplantation and may be extensive with freezing and thawing.
'Promising but Preliminary'
The researchers conclude that "it seems very likely that ovarian autotransplantation will be a realistic goal to achieve for women with cancer who receive high-dose pelvic radiotherapy."
The case represents the second successful ovarian autotransplantation. The first was reported in 1987, but it was a more involved procedure than the one performed by Hilders and her Leiden University Medical Center colleagues. Cornell University researchers have also transplanted ovarian tissue into the arms of several cancer patients.