First reported clinical pregnancy following heterotopic grafting of cryopreserved ovarian tissue in a woman after a bilateral oophorectomy

Hum Reprod. 2013 Nov;28(11):2996-9. doi: 10.1093/humrep/det360. Epub 2013 Sep 7.

Abstract

Ovarian tissue cryopreservation and transplantation is a form of fertility preservation offered to young women at high risk of losing ovarian function after cancer treatment. While there have been successful births resulting from orthotopic site grafts, we report the first case of an ongoing pregnancy from a heterotopic graft in a patient who had previously undergone bilateral oopherectomy for a granulosa cell tumour. Frozen-thawed ovarian tissue was transplanted to the anterior abdominal wall. Subsequent ovarian stimulation and transabdominal ultrasound-guided oocyte retrieval from the grafts resulted in two oocytes. These were fertilized with ICSI and two embryos were transferred. Serial ultrasounds have confirmed an ongoing 26-week intrauterine twin pregnancy. Thus, this first demonstration of a pregnancy from a heterotopic graft site provides unequivocal evidence that cryopreservation preserves complete follicle development and that normal ovarian function can occur at a non-ovarian site. This provides optimism for further efforts to assist women who have had oophorectomy and pelvic surgery or radiotherapy, without an appropriate orthotopic site for grafting.

Keywords: fertility preservation; heterotopic graft; oncology; orthotopic graft; ovarian tissue cryopreservation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Wall / surgery
  • Adult
  • Cryopreservation
  • Embryo Transfer
  • Female
  • Fertility Preservation / methods*
  • Humans
  • Oocyte Retrieval
  • Ovarian Follicle / physiology
  • Ovariectomy*
  • Ovary / transplantation*
  • Ovulation Induction
  • Pregnancy
  • Sperm Injections, Intracytoplasmic
  • Transplantation, Heterotopic