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Latest Surrogacy News
Embryo Obtained After
Breast Cancer Patient's Ovarian Tissue Is Frozen, Stored
For Six Years, And Then Reimplanted
Science Daily March 10, 2004
New York,
NY (March 3, 2004) -- For the first time,
physician-scientists at the Center for Reproductive
Medicine and Infertility (CRMI) of NewYork-Presbyterian
Hospital/Weill Cornell Medical Center have taken a
breast cancer patient's ovarian tissue that was frozen
for six years, reimplanted it under her abdominal skin,
and obtained an embryo from eggs collected from the
tissue.
The unique achievement
raises the possibility that women or girls who are about
to undergo chemotherapy, radiation, or other
ovary-damaging treatments can have their ovaries
removed, frozen, and possibly used to restore fertility
or reverse menopause at a later date. Some treatments
used for cancer and other health conditions can destroy
any chance of future pregnancy and create premature
menopause in women.
The findings were
fast-tracked for publication by The Lancet -- to be
published online on March 9 and in print on March 13.
The research study was led by Dr. Kutluk Oktay at
NewYork-Presbyterian/Weill Cornell's Center for
Reproductive Medicine and Infertility (CRMI).
"This is the first case
in medical history where an embryo has been obtained
from frozen banked ovarian tissue after ovarian
transplantation," said Dr. Kutluk H. Oktay, Associate
Professor of Obstetrics and Gynecology at Weill Cornell
Medical College and a specialist in Reproductive
Endocrinology and Infertility at NewYork-Presbyterian/Weill
Cornell's CRMI.
"This research
represents a potentially significant reproductive
advancement in two respects: first, women can preserve
their fertility by freezing their ovarian tissue, and
second, pregnancy may be possible even after the tissue
remains frozen for a long time," said Dr. Zev Rosenwaks,
co-author of the Lancet study and Director of the CRMI.
The patient was
diagnosed with breast cancer at age 30 and had an ovary
removed and frozen. Five years later, after undergoing
chemotherapy that cured her cancer, she contacted Dr.
Oktay. After undergoing extensive counseling, 15 pieces
of ovarian tissue were thawed and transplanted under the
skin in her abdomen. After three months, the tissue
began to produce hormones and eggs, and every month the
eggs were collected to undergo in vitro fertilization.
"In eight months, we
collected about 20 eggs, and eight of those were good
enough to be fertilized. We finally got an embryo that
made it to the healthy-looking four-cell stage," said
Dr. Oktay. "The embryo was transferred to the patient's
uterus although she didn't get pregnant. The chances of
pregnancy with a single embryo are limited, probably
less then 10%, so we're going to keep trying."
Dr. Oktay said the
procedure could be of interest to many types of
patients, both children and adults.
"In this country, there
are potentially several hundred thousand women and
children who could benefit from this annually," he said.
"We have patients anywhere from 6-7 years old and up,"
said Dr. Oktay.
"You could do it for
pediatric cancer patients, adults, and women undergoing
surgery for benign conditions in which you lose your
ovaries," Dr. Oktay added. "There are hematologic
diseases in which you give patients drugs that have
these side effects; it's not only for cancer."
Some types of bone
disease require radiation treatments to the pelvis,
which also damage fertility.
There's also the
possibility that the procedure could be done electively.
"Can a woman preserve a piece of an ovary for future use
against aging? This is always discussed," Dr. Oktay
said. "You might actually bank ovarian tissue --
potentially as long as you want -- and possibly preserve
fertility. But this needs to be further studied."
The procedure is
relatively noninvasive, said Dr. Oktay. "The insertion
under the skin is done with local anesthesia, as is the
egg collection," he said. "You can carry on a
conversation with the patient while it's going on."
At this point, fewer
than a dozen women worldwide have had ovarian tissue
reimplanted in their body after fertility-damaging
treatments, Dr. Oktay said.
"We don't know how long
these grafts will last; they tend not to last as long as
the typical ovary inside the body," he said.
Dr. Oktay is an
internationally recognized pioneer in the field of
ovarian cryopreservation. In his first study published
in the New England Journal of Medicine, he described the
first pelvic ovarian transplantation with cryopreserved
tissue. He published another study in 2001, reporting
the first transplantation of ovarian tissue under the
skin of the arm of two patients. In that case, the
tissue produced eggs but no embryos.
Besides Dr. Oktay and
Dr. Rosenwaks, additional co-authors include Dr. Erkan
Buyuk, Dr. Lucinda Veeck, Nikica Zaninovic, Dr. Kangpu
Xu, Dr. Takumi Takeuchi, and Dr. Michael Opsahl.
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