World’s first birth from frozen ovary

London: A woman in Belgium has given birth after doctors restored her fertility by using frozen ovary tissue removed in her childhood, in a world first that could give hope to hundreds of young cancer victims.

The 28 year old underwent surgery to remove the ovary when she was 13, before starting chemotherapy, which was likely to destroy her chances of having children.

The medical landmark could mean that in future, girls undergoing treatment for conditions such as leukaemia, sickle cell disease and sarcoma could routinely be offered such procedures to allow them to one day have a family.

Experts said that the scientific advance was an “exciting” and “important” development, which was the first of its kind, and could help shape the future of human reproductive technology.

The young woman, who has not been identified, was diagnosed with sickle cell anaemia at the age of five.

By the age of 13, her condition had become so severe that doctors in Brussels decided that a bone-marrow transplant was required. The procedure requires that the patient’s immune system is disabled, using chemotherapy or radiotherapy, to prevent rejection of the new tissue.

However, this process often destroys the functioning of ovaries, rendering patients infertile.

Surgeons in Belgium removed the girl’s right ovary and froze dozens of fragments of the tissue.

A decade later, after the young woman said she wished to become a mother, doctors led by Dr Isabelle Demeestere, a gynaecologist at Erasme Hospital in Brussels, began attempts to restore her fertility.

Fifteen fragments of ovarian tissue were thawed, with four grafted on to the remaining left ovary, which was no longer functioning.

Because the organ had atrophied, surgeons were unable to graft more tissue to it, so 11 further fragments were secured under the skin and in the area around the abdomen.

This triggered a hormonal response in the body, the growth of follicles containing maturing eggs, and the start of menstruation.

However, the patient only became pregnant two years later — at the age of 27 — after she discovered that her previous boyfriend was infertile and she started a new relationship.

The woman, who was born in the Democratic Republic of Congo but moved to Belgium before the age of 11, gave birth to a healthy boy in November 2014, weighing just under 3.1kg.

The details are released today in the journal Human Reproduction.

Dr Demeestere said: “This is an important breakthrough in the field because children are the patients who are most likely to benefit from the procedure in the future.

“When they are diagnosed with diseases that require treatment that can destroy ovarian function, freezing ovarian tissue is the only available option for preserving their fertility.”

She added that in the case of the young woman, her “ovary continues to function normally and her doctors say there is no reason why she could not have more babies if she wants to”.

Over the past 15 years, Dr Demeestere’s team in Brussels have stored tissue from about 50 girls who are undergoing medical treatment, she said, but the 28 year old is the first to seek to start to have a family.

Professor Adam Balen, from the Leeds Centre for Reproductive Medicine, said: “The option of freezing ovarian tissue gives the opportunity to preserve fertility for later. “This procedure has been carried out many times now in adults and several pregnancies have been reported worldwide.

“There had previously been uncertainty as to whether ovarian tissue taken from young girls would later on be competent to produce mature, fertile eggs, so today’s case is both reassuring and exciting.”

Balen said the technology to carry out ovarian transfer was only available in a few centres, but was expected to become routine in years to come. However, he warned that children requiring chemotherapy are very ill, and that surgery to remove ovarian tissue “is no small undertaking”. Professor Jane Maher, joint chief medical officer at Macmillan Cancer Support, said: “This is a remarkable case and will give hope to those who may have their fertility affected by cancer treatment. However, these are still very early findings and we need to do more to understand the impact this will have in the long term.” She said there was a need to do more to understand the impact cancer treatment could have on patients’ quality of life many years later. Martin Ledwick, head cancer information nurse at Cancer Research UK, said: “Researchers have been looking for ways to preserve fertility using ovarian tissue for some time, so it’s exciting to see progress being made. But there’s still a lot more we need to understand.

“The decision about treatment and fertility is very different for people of different ages, so it’s important that patients have a full discussion with their doctor, as well as their partner or parents.”