Welcoming a new baby is always a joyful occasion, but for one Belgian woman, she needed to make history in order to do it.
The woman, who has chosen to remain anonymous, had one ovary removed at the age of 13 before she received a bone marrow transplant to treat an advanced case of sickle cell anemia. Before she could receive a bone marrow transplant, the girl, who had recently emigrated from the Republic of Congo, needed to undergo chemotherapy and wipe out her entire immune system so any old cells wouldn't attack the transplanted cells. As an unfortunate side effect, her remaining ovarian function was completely wiped out, rendering her infertile.
At the age of 27, the tissue was transplanted back into her body and she was able to give birth to a 6 pound, 9 ounce son in November 2014.
This is the first time that a juvenile tissue transplant has successfully reversed infertility. It is unclear if she will be able to conceive again using this tissue, but if not, she still has some frozen tissue that could be used if necessary.
The case was described in the journal Human Reproduction. The study was led by Isabelle Demeestere of Université Libre de Bruxelles, who believes it could be an important advancement for children with extreme medical conditions that could compromise their fertility down the road.
"This is an important breakthrough in the field because children are the patients who are most likely to benefit from the procedure in the future," Demeestere explained a press release. "When they are diagnosed with diseases that require treatment that can destroy ovarian function, freezing ovarian tissue is the only available option for preserving their fertility."
Being that this is the first time it has been successfully achieved, researchers still need to determine what factors were present in this case that would make it work for others.
In this case, the ovarian tissue was removed when the subject was 13 years old and had not started menstruating yet, thought she was showing signs of pubescent growth in her breasts. Additionally, there are concerns about whether it would be ethical to use ovary grafts to induce puberty after treatment, or if it should be reserved for fertility purposes. There's also the issue of deciding who the best candidates for such an invasive procedure are.
"Should the procedure only be proposed for patients with a high risk of ovarian failure or for those at low risk as well? We think, at present, that cryopreserved ovarian tissue should be used only for fertility restoration in patients at high risk of ovarian failure, and not for puberty induction or for restoring menstrual cycles in adults," Demeestere explained.
[Image credit: Erasme Hospital, Université Libre de Bruxelles]