Four spontaneous pregnancies and three live births following subcutaneous transplantation of frozen banked ovarian tissue: What is the explanation?

作者：Oktay Kutluk^*; Tuerkcueoglu Ilgin; Rodriguez Wallberg Kenny A

来源：Fertility and Sterility, 2011, 95(2): 804.e7.

DOI：10.1016/j.fertnstert.2010.07.1072

• Fertility preservation
• cancer
• Hodgkin disease
• ovarian cryopreservation
• ovarian transplantation
• heterotopic
• pregnancy
• live birth

Objective: To report the long-term follow-up of an experimental heterotopic ovarian transplantation with frozen-thawed ovarian tissue.
Design: Long-term follow-up of an experimental surgery; case report.
Setting: Academic reproductive medicine center.
Patient(s): A 28-year-old cancer survivor with previous Hodgkin disease and relapse.
Intervention(s): Laparoscopic oophorectomy for ovarian cryopreservation before preconditioning chemotherapy for hematologic stem cell transplantation. Ovarian tissue thawing and subcutaneous heterotopic ovarian transplantation in the lower abdominal wall 2 years after the hematologic stem cell transplantation.
Main Outcome Measure(s): Resumption of ovarian function after transplantation, recovery of fertility, and pregnancy outcome.
Result(s): Follicle development was observed in the graft 2 months after transplantation, and a P value of 14 ng/mL indicated ovulation. The patient conceived spontaneously four times within 5 years and delivered three children. The in situ ovary remained atrophic but showed occasional follicle activity contemporaneously with the graft.
Conclusion(s): The mechanism behind spontaneous restoration of fertility with consecutive viable pregnancies after a heterotopic ovarian transplantation needs to be explored. Further laboratory and clinical research will be needed to explore the true origin of pregnancies after ovarian transplantations. (Fertil Steril (R) 2011;95:804.e7-e10.

• 出版日期2011-2