A 23-year-old woman may soon become pregnant after receiving an implant of an ovary that had been frozen since she was eight years old.
Moaza Alnatrooshi, who is from Dubai, had the ovary removed before undergoing chemotherapy treatment for beta thalassaemia. At the age of 21 her remaining ovary was only partially functioning and she showed signs of early menopause.
Dr Sara Matthews, consultant gynaecologist at the Portland Hospital, London, arranged for the frozen ovary to be transported to Denmark, where doctors specialising in ovarian tissue freezing and transplantation performed the surgery in August last year.
After the procedure, Alnatrooshi's hormone levels returned to normal. Eight eggs were collected and were fertilised by IVF, leading to three embryos, which have been frozen. One of the embryos is due to be implanted next month, and if she becomes pregnant, Alnatrooshi will become the first women to become pregnant using an ovary stored before puberty.
Frozen ovarian tissue taken from adult patients has previously been used to restore fertility, so far resulting in the birth of 40 babies. However, there has been some doubt over whether the procedure would work using tissue from pre-pubescent children, whose reproductive organs have not fully matured.
Last year a woman become pregnant from ovarian tissue stored at the age of 13, when she had just started puberty (see BioNews 806). In that case doctors grafted four fragments of ovarian tissue onto the woman's non-functioning left ovary and also her abdomen. The tissue induced a hormonal response, causing her to begin menstruation, and the woman conceived naturally two years later at the age of 27.
Ovary and ovarian tissue transplants could provide a fertility option for women wanting to have genetically related children but who could not freeze their eggs or create embryos to preserve their fertility.
'This allows young girls who develop cancer or have other conditions that require chemotherapy, like beta thalassaemia, to have children where the vast majority, over 90 percent, would not be able to have their own children. There is no other way at the moment to do it,' said Dr Matthews.
'You cannot grow eggs. You can't do IVF [before the chemotherapy] because they haven't gone through puberty. It is the only option for them and we have been able to prove that, in practice, it works.'
Professor Claus Yding Andersen at the Rigshospitalet, University of Copenhagen, who arranged the operation in Denmark, said: 'If Moaza becomes pregnant this will be the first pregnancy where eggs were derived from ovarian tissue removed at an early age, prior to puberty. Just the fact that such eggs can be fertilised successfully raises hope for the many young girls who will, unfortunately, experience childhood cancer.
'Hopefully this case will lead to the more widespread use of this procedure in the UK.'
The Sunday Times reports that St George's Hospital in London is to offer ovary freezing in collaboration with Professor Andersen and his colleagues.