The first case in Russia
A woman cured of cancer became pregnant herself after ovarian tissue transplantation
Reproductologists and gynecologists of the Center for the Preservation of Fertility of Cancer Patients (clinic "Scandinavia AVA-PETER") in 2013 performed ovarian tissue transplantation to a patient who was cured of Hodgkin's lymphoma by courses of high-dose chemotherapy. After that, she was able to get pregnant and give birth to a child with the help of assisted reproductive technologies (ART). And after a few years of operation of the transplanted ovary, the woman had a second pregnancy – spontaneous (that is, natural) – and another healthy child was born. This is the first case of natural pregnancy after ovarian tissue transplantation in Russia.
According to experts, the restoration of fertility (the ability to conceive) in women after cancer treatment is one of the key challenges of rehabilitation medicine, as it is directly related to the quality of life of the patient. The fact is that courses of high-dose chemotherapy can completely destroy the function of the ovaries, depriving women of the opportunity to have children even after the onset of stable remission.
The solution to this problem can be cryopreservation and transplantation of ovarian tissue, which is taken from the patient before starting cancer treatment.
This technology is still considered experimental, but has already shown high performance: thanks to it, more than 130 children have already appeared in the world. Moreover, half of their parents became pregnant spontaneously, that is, without assisted reproduction (IVF, ICSI, and so on).
"It takes only two days to perform cryopreservation of ovarian tissue. This is extremely important when antitumor treatment should be started immediately. Ovarian tissue is obtained by laparoscopy, cryopreserved and stored in a cryobank while the patient undergoes antitumor treatment. When remission occurs, the patient and the oncologist decide to return the tissue to its place. To do this, we perform laparoscopic surgery: the ovarian tissue is thawed and transplanted into the pelvic cavity to its natural place. After that, it takes root within a few days and after a few months we begin to observe the growth of follicles and the development of eggs," says Olga Bystrova, Candidate of Biological Sciences, embryologist at the clinic "Scandinavia AVA–PETER".
A patient of the clinic who had a spontaneous pregnancy, after transplantation, first applied for an ART procedure and in 2015 gave birth to her first child with IVF. However, a few years later, thanks to the work of the transplanted ovarian tissue, pregnancy occurred independently, and a completely healthy girl was born in December 2017.
By the way, we note that research in this area has been actively conducted since the 1920s. It was possible to preserve the tissue structure of many mammals, but it was not possible to do this in humans. 80 years later, in 1994, the first successful protocol for cryopreservation of human ovarian tissue appeared. It was developed by scientists from England, and many countries still use this cryopreservation protocol. Russia has taken into account the experience of Western colleagues, but has developed its own method of cryopreservation of ovarian tissue.
The results of the work of the team of doctors were published in the journal "Problems of Reproduction" in May 2019 (Bystrova et al., Spontaneous pregnancy after transplantation of cryopreserved ovarian tissue: a clinical case).
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