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Last Updated: Monday, 8 November, 2004, 00:12 GMT
'Ovary-arm' transplant a success
Image of an egg
The whole ovary is re-sited
A woman undergoing cancer treatment has had her fertility saved after doctors transplanted her ovary into her arm.

Dutch surgeons at Leiden University hope she could become the first woman in the world to become pregnant thanks to the procedure.

The technique has the advantage of keeping the ovary whole and intact with a good blood supply, which should improve success rate, say the authors.

The findings are published in the journal Cancer.

Fertile

Scientists have been looking at different ways to avoid infertility due to cancer treatment.

Some have frozen eggs from the woman that can later be fertilised using IVF and transferred to the womb.

Others have looked at freezing pieces of ovarian tissue from women before cancer treatment and replacing them on the ovary once the course of therapy is completed.

Potentially this technique could be better because you are not having to deep freeze the tissue and you are maintaining the blood supply
Dr James Catt, lead embryologist, IVF Centre, St James' Hospital in Leeds
The most famous example of this was Ouarda Touirat, 32, who conceived naturally and gave birth to a baby girl this year after her ovarian tissue was removed and frozen seven years ago before chemotherapy, then re-implanted into her pelvis last year.

However, the success of these transplants can be hampered by poor blood supply.

Dr Carina Hilders and her colleagues believe that by moving the whole of the ovary and its blood vessels and attaching it to blood vessels in the arm, the success rate will be greatly improved.

Back in 1987, a French team tried the same technique on a young woman with Hodgkin disease with good results. However, for personal reasons, the woman has not attempted a pregnancy since.

Dr Hilders' team carried out the same technique, called ovarian autotransplantation, in a 29-year-old woman who had been diagnosed with cancer of the cervix.

Re-sited

During the surgical treatment for the cervical cancer, they removed one of the patient's ovaries and transplanted it to the front of her left upper arm.

After the surgery the transplanted ovary functioned normally.

The authors said: "It seems very likely that ovarian autotransplantation will be a realistic goal to achieve for women with cancer."

However, they pointed out that it would not be suitable for women treated with chemotherapy because this cancer treatment targets the whole body and could potentially damage the ovaries regardless of where they are located in the body.

Image of Tamara Touirat
Tamara Touirat is the first baby reported to be born to a woman after an ovary transplant

Dr James Catt, lead embryologist at the IVF Centre, St James' Hospital in Leeds, UK, said: "It's quite novel because nobody has really done this before.

"What people have been looking at before is removing part or all of the ovary and chopping it up into small pieces and then deep freezing them.

"That comes at a price because when you thaw out that tissue not all of the tissue will survive. Then it has to be grafted back and you have to hope that the tissue will recover.

"So potentially this technique could be better because you are not having to deep freeze the tissue and you are maintaining the blood supply."

But he said it would mean that the woman would be limited to IVF treatment if she wanted to become pregnant.

"You would stimulate the ovary in the arm and recover an egg from the arm and then do IVF.

"Whereas with freezing an ovarian slice you can put it back into the right place on the ovary and you can conceive in the usual way. You are not restricted to IVF."

He said that, with any method, you would have to be sure that the ovary did not contain any cancer cells.


SEE ALSO:
Baby for ovary transplant woman
24 Sep 04 |  Health


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