June 7, 2005 -- A 24-year-old woman has given birth months after receiving an ovarian transplant from her identical twin sister.
The baby was conceived naturally, without help from techniques such as in vitro fertilization (IVF), says the report in The New England Journal of Medicine's online edition.
The women's circumstances were very rare. However, the outcome could have "broader implications for preserving fertility in young women, such as those who require potentially sterilizing treatment for cancer," write the twin's health care team. The team included Sherman Silber, MD, of St. Luke's Hospital in St. Louis.
New Mom Had Been Infertile for 10 Years
The identical twins were 24 years old. One twin had had three children; her sister had premature ovarian failure and had been infertile for a decade. The infertile twin had only had three years of "scanty" menstrual periods, which ended when she was just 14 years old, says the report.
Wanting children, the woman first tried egg donation and IVF at another clinic. The eggs were donated by her twin sister, but the attempts failed.
Then, the women decided to take another approach. The infertile woman said she didn't want to try IVF again. Instead, she received a graft of ovarian tissue from her identical twin sister.
The graft went in the same area where the ovaries are. Because the tissue used for the ovarian transplant came from her identical twin, the woman's body accepted the donation without needing drugs to suppress the immune system.
Bouncing Baby Girl
Within three months of the procedure, the woman's menstrual cycles resumed and her hormone levels were back on track. She conceived naturally during her second cycle, and the "uneventful" pregnancy resulted in an apparently healthy baby girl, say Silber and colleagues.
Trying to Preserve or Revive Fertility
"The possibility of ovarian transplantation in humans is receiving increased attention," say the researchers. "Some centers offer to bank ovarian tissue of young patients with cancer, with the aim of restoring fertility by transplanting thawed ovarian tissue after they are cured or in long-term remission."
"If ovarian transplantation is proven to be safe and effective in humans, fertility preservation might become readily available for young women who need to delay childbearing for medical or social reasons," says the report.
Recent Reports of Success
Last November, Dutch researchers reported that they had cancer treatment, produced hormones normally in the woman's arm.The ovary, removed before
The arm was chosen for convenience. If the woman wanted to get pregnant, she would need reproductive technology, and it would be relatively easy to harvest her eggs from her arm, Dutch researchers told WebMD last fall. That woman had not tried to conceive due to her cancer's return, doctors reported last fall.
Another woman who was thought to be sterile after treatment for Hodgkin's disease, a cancer of the lymph nodes, reportedly got pregnant after an ovarian graft, say Silber and colleagues. The woman had banked her own tissue, but there are questions about whether her pregnancy was due to the graft or to tissue near the graft, says Silber's report.
That's not an issue in the twins, says Silber. He calls their case a compelling demonstration that ovarian grafts can restore fertility.
The report will also appear in the journal's July 7 print edition.