Belgian doctors have announced the first successful transplant of ovarian tissue between non-identical sisters; and are reported to have fertilised a subsequent embryo. Although the embryo failed to develop, the procedure may offer new hope to women who become infertile following cancer therapy.
Teresa Alvaro became infertile after undergoing chemotherapy and radiotherapy to treat an inherited blood disorder. Having been told that the eggs in her ovaries had been destroyed by the aggressive chemotherapy and radiotherapy, Teresa gave up hope of naturally conceiving a child until reading an article claiming that an American woman had received ovarian tissue from her twin sister, and subsequently become pregnant. Teresa then contacted Jacques Donnez, from the Catholic University of Louvain in Brussels, asking about the possibility of her receiving ovarian tissue from Sandra.
The procedure, which involved transplanting three small strips of Sandra's ovarian tissue into Teresa, was undertaken successfully. The operation was more likely to be successful because Teresa had received and earlier bone-marrow transplant from her sister; because Teresa's immune system is built from Sandra's cells it did not reject the transplant and there was no need for immune-suppressing drugs. Seven months after the transplant Teresa began to menstruate, within a year the transplanted ovarian tissue began to produce eggs. Doctors then took two mature eggs from Teresa and fertilised them with her husband's sperm. Although the fertilisation was successful, the embryos failed to develop beyond the three-cell stage and doctors decided not to implant them. Mr Donnez commented: 'we do not know why the embryos ceased to develop, but this also happens during normal cycles of in IVF'.
Teresa has stated her intention to undergo further cycles of IVF.
The success of the operation gives hope to women who become infertile due to cancer treatment. Dr Allan Pacey, Secretary of the British Fertility Society, commented that the most likely use of the procedure would be on women who had their own ovarian tissue removed and frozen before cancer treatment, and replaced once their treatment had come to an end. He said 'the science that underpins this type of transplant will be of great benefit in developing realistic fertility preservations options for young women who want to preserve their fertility prior to cancer treatment'. However, he also speculated that there could be a move towards woman to woman transplants, should suitable willing donors come forward.