Successful Ovarian Transplant Presented in Toronto

One of the most publicized papers of the 1999 American Society of Reproductive Medicine/ Canadian Fertility and Andrology Society was the research presented by Dr. Oktay, Dr. Karkujaya, Dr. Gosden and Dr. Schwartz from Cornell University in New York and and from the University of Leeds in the UK. They successfully auto-transplanted frozen-banked ovarian tissue and demonstrated the resumption of ovarian function.

The 28 year-old woman had had both of her ovaries removed for teratomas, and parts of the normal ovarian tissue had been cryopreserved. Six months after the last oophorectomy she contacted the authors via the Internet, and after extensive consultations the ovarian strips were shipped to them. At that time the woman was on 0.75mg of transdermal estradiol with low circulating levels of FSH and LH. Cultures of the preserved tissue showed there remained healthy ovarian tissue, and the remaining pieces of ovarian tissue were sutured onto a small frame and placed by laparoscopy into a pocket in the broad ligament.

Ultrasound demonstrated blood flow to the transplanted tissue three weeks after implantation, and administration of human menopausal gonadotropins three months after implantation stimulated follicular development in the tissue. At a maximum follicular size of 16.5 mm, HCG was administered with a progesterone rise 36 hours after the injection. The authors suggested this might be an alternative approach to women of reproductive age who lose ovarian function secondary to extrinsic factors.