First baby born after reimplantation of ovarian tissue
Late in 2015 a woman gave birth to a baby conceived following the reimplantation of thawed ovarian tissue. The woman was able to become pregnant thanks to transplantation of the tissue that took place in the LUMC.
Infertile from cancer
The woman had become infertile as a result of cancer treatment. The only place in the Netherlands where this innovative treatment takes place is in the Leiden University Medical Center (LUMC). This is the first time it has led to an advanced pregnancy and the birth of a healthy child.
Newly matured egg cells
The ovarian tissue was removed from the woman before she underwent chemotherapy. Doctors removed one of her ovaries, the outer shell of which, containing immature egg cells, was then frozen. Three years later the tissue was thawed and replaced in the remaining ovary and under the stomach lining. Egg cells matured in the tissue that had been replaced, explained Lucette van der Westerlaken, head of the IVF laboratory at the LUMC. 'The woman then became pregnant with the help of IVF. Following a normal pregnancy, she gave birth to a healthy baby last November. This is unique in the Netherlands, and even worldwide only sixty children have been born as a result of this treatment. Around 40 children have been born after the mother was treated for cancer.'
Too little time
Young women who have to be treated for cancer can become infertile as a result of chemotherapy or radiotherapy. Freezing egg cells can make it possible for these women to have a child at a later date. But if the treatment has to be started in a hurry, there is often too little time for the hormonal stimulation of the ovaries, which is needed for successful removal of the ovary. 'For these women, freezing and later reimplanting ovarian tissue may be an alternative, acording to gynaecologist Leoni Louwé. 'There are a number of criteria that the women have to meet, such as their age and the risk of the cancer spreading to the ovary.'
The LUMC is one of the leading centres for IVF in the Netherlands and it is the only centre in the country that reimplants overian tissue. Since 2002 seventy women have had tissue removed and frozen. So far, five of the women have had ovarian tissue reimplanted and in one women the procedure has led to a successful pregnancy. 'As an IVF lab, we have a lot of expertise in freezing and thawing ovarian tissue,' explained Van der Westerlaken. 'We are also carrying out a lot of research to refine this new technique and make it more efficient. For example, by looking at how we can improve the survival and working of the ovarian tissue.'
The option to have ovarian tissue frozen is currently only being offered to a select group of women who have to undergo cancer treatment, and incidentally to young women who, as a result of medical treatments, run a high risk of infertility. We are seeing that more and more practitioners are aware of our work and are alerting women to the possibilities of this treatment,' commented Louwé. In the future it will also become possible to have egg cells mature in the lab in thawed ovarian tissue. The risk that reimplanting the tissue may mean that the cancer also returns can then be countered. The researchers expect the technique will have wider applications in the future.