Infertility roundup

Infertility first: Live birth with ovarian tissue frozen in childhood

In a world first, a woman has delivered a healthy boy after transplantation of her own ovarian tissue that was cryopreserved during childhood. Reporting on the case in Human Reproduction, Belgian researchers said the outcome “offers reassuring evidence for the feasibility” of cryopreservation of ovarian tissue prior to puberty.

Age 27 when she gave birth, the mother received a diagnosis of sickle cell anemia at age 5.  At age 13 years and 11 months, she underwent a right oophorectomy with removal and cryopreservation of 62 fragments of ovarian tissue. The fertility-sparing procedures were approved by her parents in advance of their child’s treatment with chemotherapeutic conditioning followed by hematopoietic stem cell transplantation.

At the time of cryopreservation, the patient had undergone puberty but had not menstruated. When she was age 15 ½, menarche was induced with a third-generation estrogen-progesterone preparation.

 At age 25, because the patient wanted to become pregnant, grafting of thawed ovarian tissue was performed. Four segments were grafted on the residual left ovary, six were grafted in the right peritoneal bursa, and five were grafted subcutaneously using a trocar incision. From the time the woman began to menstruate 5 months later, her menstrual cycles were regular. For two years thereafter and with a partner with male infertility, she did not conceive. The pregnancy that resulted in the historic live birth was spontaneous and with a new partner.

Cryopreservation of ovarian tissue is common, the authors said, to preserve fertility in children but their report provides “evidence for the long-term survival of autografts of ovarian tissue cryopreserved before menarche and the efficiency of the procedure to restore fertility.”