A 38-year-old woman is due to give birth next week after the first ever whole ovary transplant to result in a successful pregnancy.
The woman, who lives in London and whose ovaries stopped working when she was 15, became pregnant just over a year after receiving a donor ovary from her identical twin sister.
The transplant technique will have limited application among women who are not twins because a transplanted ovary would produce genetically different eggs. For these patients it would be simpler to have IVF with donor eggs.
However, the technique offers the possibility of removing and freezing an ovary prior to cancer treatment such as radiotherapy and chemotherapy.
The transplant was carried out in the US early last year by Dr Sherman Silber at the Infertility Centre of St Louis in Missouri. The patient had experienced an early menopause at age 15 when her ovaries stopped producing hormones.
Her twin sister, who has two children, donated one of her ovaries which the surgical team removed using keyhole surgery. Because both women are genetically identical, eggs from the donor ovary are equivalent to those produced by the patient herself.
Transplanting the ovary into the patient involved microsurgery to reconnect blood vessels as small as half a millimeter in diameter. Three months after the surgery, the patient had her first period in 22 years, indicating that she was ovulating normally again.
"To our knowledge, this is the first successful human intact whole ovary transplant leading to healthy pregnancy," said Silber. He will present his results tomorrow at the American Society of Reproductive Medicine's annual meeting in San Francisco.
The surgical tour de force follows previous successes by Silber with ovary graft transplants in which a slice of ovary tissue is grafted onto an infertile patient's own ovary. The first graft transplant to produce a successful pregnancy happened in 2004, also between two twin sisters.
Silber also presented two other studies at the conference in which his team tested techniques for freezing ovaries for future transplant. In total, the team successfully preserved 27 ovaries, and for the first time five fallopian tubes.
"This sets the stage for a new chapter in reproductive organ transplantation," said Silber. "In addition to whole ovary transplantation it is possible now to consider fallopian tube transplant for women with irreparable tubal disease."
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