Abu Dhabi: An Emirati from Dubai has become the first woman in the world to deliver a healthy baby using ovarian tissue frozen before the onset of puberty.
“It has been a long road, but she now has a healthy baby boy, her doctor told Gulf News.
Moza Al Matroushi, a 24-year-old, delivered a healthy baby boy in London on December 13.
Dr Sara Matthews, consultant gynaecologist and fertility specialist at the Portland Hospital in London, said no other person has had ovarian tissue transplanted 14 years after it was first frozen, and that this is first case in which ovarian tissue taken before puberty has restored fertility in an adult woman.
"And this success opens the doors for much more research into tissue freezing and transplantation,” she said.
“It was also very far-sighted for her mother. She insisted, in 2001, when [Al Matroushi] was just nine, that her daughter’s ovarian tissue be frozen before a bone marrow transplant just so that she would have a chance at starting a family down the line,” she added.
Matroushi was diagnosed with beta thalassaemia, an inherited blood disorder, at a young age. After one of her similarly affected younger brothers succumbed to the disease, her parents decided to get her a bone marrow transplant.
To destroy all the affected blood cells before her bone marrow transplant, Al Matroushi had to undergo chemotherapy. There was a 99 per cent chance that this would damage her ovarian function, so doctors suggested she freeze her ovarian tissue.
Al Matroushi’s right ovary was removed via keyhole surgery by a team of specialists at the University of Leeds. It was cut into seven two-millimetre-thick slivers and frozen in liquid nitrogen at a temperature of -195 degree Celsius. She then underwent the treatment and the bone marrow transplant cured her thalassaemia.
After her marriage, Al Matroushi and her husband tried to get pregnant to no avail. She then approached Dr Matthews in 2014.
“Her remaining ovary was failing and she was menopausal at the age of 22 years. We tried stimulating the ovary for four months but in the end, no eggs appeared to be left. So we looked into options for an ovarian transplant,” Dr Matthews recounted.
Because the ovary had been frozen before the 2004 implementation of the European Union Tissues and Cells Directive, facilities in England were reluctant to transplant it. So in August 2015, Al Matroushi and Dr Matthews flew to Copenhagen for the procedure.
“We transplanted five of the slivers, and soon, her menopause had been reversed and she was getting her periods again. We could have chosen to wait for a normal pregnancy, but decided not to risk it,” Dr Matthews said.
In April, Al Matroushi and her husband underwent in-vitro fertilisation (IVF). Eight mature eggs were collected for the procedure, and they yielded three healthy embryos, of which two were implanted.
“She went on to have a straightforward pregnancy, and Rashid was delivered in the 39th week. He was a healthy 3.2 kilograms at birth,” Dr Matthews said.
The doctor said the third embryo has been frozen at present.
“After she has finished nursing, assuming her ovarian function returns to normal, we hope to help her have two to three children,” Dr Matthews said.
Matroushi is now recovering after her Caesarean section, but cannot wait to get home to Dubai. Her husband and her mother-in-law are staying with her in London.
“She will be able to fly back after her son is six weeks old, and is dying to get back to her parents and other family members,” Dr Matthews added.
The successful birth presents "enormously valuable" news for the parents of young girls requiring risky medical treatments — such as chemotherapy — that can damage ovaries, said Helen Picton, who leads the division of reproduction and early development at the University of Leeds in England and carried out Al Matroushi's ovary freezing. The case provides evidence that doctors could potentially restore fertility in these women by freezing their ovary tissue at a very young age, she said.
"She and her family really are courageous — and pioneers — to have done this," Picton said in a phone interview with The Washington Post. "It's tremendously hopeful technology because you're investing in the future fertility life of your daughter."
In an interview with the BBC, Al Matroushi said the birth of her baby was "like a miracle".
Moza Al Matroushi with her newborn baby in Portland hospital, London. BBC
"We've been waiting so long for this result," Al Matroushi said. "A healthy baby."
“I always believed that I would be a mum and that I would have a baby," Matroushi told the BBC. "I didn't stop hoping and now I have this baby — it is a perfect feeling.”
Timeline
2001: Moza Al Matroushi freezes her right ovary prior to undergoing a bone marrow transplant. The transplant cures her beta thalassaemia, an inherited blood disorder that had killed one of her younger brothers.
2004: First baby born after ovarian tissue from an adult woman in Belgium is transplanted.
2014: Al Matroushi’s remaining ovary appears to be failing and she is nearly menopausal. She has had no success in getting pregnant.
August 2015: Al Matroushi undergoes ovarian tissue transplantation in Denmark. Her pre-pubertal ovarian tissue restores her fertility within three months, and she goes back to having regular periods.
April 2016: Al Matroushi and her husband, Ahmed, undergo in-vitro fertilisation in London. Two healthy embryos are implanted, and Al Matroushi gets pregnant.
December 13, 2016: Rashid is born after a healthy pregnancy, and weighs 3.2 kilograms at birth. He is delivered at the Portland Hospital in London.
— With inputs from The Washington Post
