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Acta Obstet Gynecol Scand. 2015 Mar;94(3):324-8. doi: 10.1111/aogs.12568. Epub 2015 Feb 2.

Full-term newborn after repeated ovarian tissue transplants in a patient treated for Ewing sarcoma by sterilizing pelvic irradiation and chemotherapy.

Author information

1
Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden; Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.

Abstract

We report the first successful transplantation of cryopreserved ovarian cortical tissue into heavily irradiated tissues in a patient who had received sterilizing pelvic radiotherapy (54 Gy) and 40 weeks of intensive high-dose chemotherapy for the treatment of Ewing's sarcoma 14 years earlier. Repeated transplantation procedures were required to obtain fully functional follicular development. Enlargement of the transplants over time and increase of the size of the uterus were demonstrated on sequential ultrasonographic examinations. Eggs of good quality that could be fertilized in vitro were obtained only after a substantial incremental increase of the amount of ovarian tissue transplanted. Single embryo replacement resulted in a normal pregnancy and the birth of a healthy child by cesarean section at full-term. No neonatal or maternal postoperative complications occurred. Women facing high-dose pelvic radiotherapy should not be systematically excluded from fertility preservation options, as is currently the trend.

KEYWORDS:

Cancer; chemotherapy; fertility preservation; iatrogenic ovarian failure; live birth; ovarian tissue cryopreservation; ovarian transplantation; pregnancy; survivorship; uterine irradiation

PMID:
25545009
PMCID:
PMC4671259
DOI:
10.1111/aogs.12568
[Indexed for MEDLINE]
Free PMC Article

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