Fertility Society of Australia Annual Scientific Meeting, Sydney

Fertility Society of Australia Annual Scientific Meeting, Sydney

Media Release Monday 2 September 2013

EMBARGO TO 3.30pm MONDAY 2 September, 2013

Australian fertility specialists achieve world’s first pregnancy from ovarian tissue grafted outside woman’s pelvis

Researchers from the leading fertility preservation service at Melbourne IVF and The Royal Women’s Hospital have achieved the world’s first on-going pregnancy from tissue removed from an ovary of a woman undergoing cancer treatment and later grafted to her abdominal wall.

The Melbourne woman, Vali, (first name only) sought the tissue preservation treatment to help save her fertility after the loss of ovarian function through cancer treatment.

Prior to surgery to remove her second ovary at the age of 23, she requested the ovarian tissue be frozen.

Seven years after the cancer treatment that left her menopausal, Vali asked for the frozen ovarian tissue to be thawed and grafted back to help her conceive a baby with her own eggs.

Freezing and transplantation of ovarian tissue back into the original position in the pelvis, known as orthotopic transplantation, has resulted in 29 births world-wide.

However, heterotopic transplantation – where ovarian fragments are grafted at alternative sites distant from their physiological location, including the abdomen and breast – has until now not resulted in clinical pregnancy.

With the supply of blood and stimulating hormones to increase the viability of the transplanted tissue, follicle development can occur and mature eggs can be retrieved from the heterotopic site. Once harvested, IVF can be employed.

Vali, who had the ovarian tissue grafted to the anterior wall of her abdomen, is now 25 weeks into her pregnancy and is expecting twins.

The pioneering procedure, reported at the annual scientific meeting of the Fertility Society of Australia in Sydney today (Monday), is a triumph for a team of fertility specialists at Melbourne IVF, led by its Head of Fertility Preservation, Associate Professor Kate Stern, and the Royal Women’s Hospital (the Women’s).

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The research is also to be published in Europe’s leading reproductive medicine journal, Human Reproduction.*

This pioneering team includes:

Dr Lyndon Hale, Medical Director Melbourne IVF, who led the surgical procedure;
Dr Debra Gook, the scientist who developed the laboratory processes for the freezing and thawing of ovarian tissue;
Associate Professor John McBain, who heads the Reproductive Services at the Women’s; and
researchers, scientists and nurses who are all intensively involved in this program.

Associate Professor Stern, who is also head of the Medical Preservation of Fertility Special Interest Group of the Fertility Society, said improvements in cancer therapy had resulted in long-term survival from many malignancies.

However, a significant proportion of patients are left infertile because of the toxic effects of some cancer treatments, or because of the surgical removal of their reproductive organs.

Associate Professor Stern said the woman and her partner, Dean (first name only) had received extensive counselling about the risk of tumor cell transmission through the grafting procedure, but comprehensive and repeated tests in association with her oncologist had shown no evidence of this occurring.

“Seven months after a second graft of the thawed ovarian tissue, during a cycle of gentle IVF hormone stimulation, two follicles were found in the abdominal wall graft site,” she explained.

“This very mild stimulation cycle resulted in two oocytes, or eggs, being retrieved from the follicles in the abdominal wall. Single sperm injection was performed on both oocytes with subsequent fertilisation through IVF and the two embryos were transferred into the patient’s uterus three days later.

“Subsequent ultrasound tests have shown that the twin pregnancy is proceeding normally.

“This is the first demonstration of an on-going pregnancy from a heterotopic graft site and it provides renewed optimism for women who are facing ovarian surgery or radiotherapy to treat cancer.

“There is no doubt the eggs have come from the transplanted tissue on the abdominal wall.

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“Most importantly, this pregnancy provides unequivocal evidence that cryopreservation, or freezing of the ovarian tissue, preserves follicle development and that normal ovarian function and pregnancy can occur at a non-ovarian site.

“We are now introducing a new program for retrieval and transport of ovarian tissue from other centres for cryopreservation and storage in our centre.

“This will allow patients being treated outside the major centres to have the optimal opportunity for cryopreservation of their precious ovarian tissue.”

Interview:

Associate Professor Kate Stern and key research team members will participate in a media conference at the Fertility Society of Australia meeting at the Hilton Hotel, Sydney at 3.15pm on Monday 2 September.

Photographs and broadcast quality vision of the pregnant woman and her partner are available on-line (See link)

Further Information:

Trevor Gill, FSA Media Relations on 0418 821948

Nicole Phillips, IVF Australia on 0408 280 499.

Research Team:

The team responsible for this groundbreaking development includes:

Associate Professor Kate Stern, Head of the Fertility Preservation Service at Melbourne IVF (MIVF) and the Women’s, Head of Clinical Research at MIVF and Head of the Endocrine and Metabolic Unit, the Women’s;
Dr Lyndon Hale, Head of Reproductive Surgery at the Women’s and Medical Director at MIVF;
Associate Professor John McBain, Head of Reproductive Services, the Women’s and Senior Fertility Specialist at MIVF;
Dr Debra Gook, lead scientist of the oocyte and ovarian tissue cryopreservation program at the Women’s and MIVF;
Dr Franca Agresta, Clinical Research Manager, the Women’s and MIVF;
Dr Manuela Toledo, senior fertility specialist MIVF;
Dr Jacqueline Oldham and Dr Amanda Sampson, gynaecology ultrasound specialists;
Associate Professor Tom Jobling, gynaecological oncologist; and
Dr Petra Wale, Ms Stacey Gwilim and Ms Nicole Merry, senior scientists and laboratory managers, MIVF.
Special acknowledgement to Professor Claus Yding Andersen, Head of the Laboratory of Reproductive Biology, University Riks Hospital, Copenhagen, and Professor Dror Meirow, Professor of Obstetrics and Gynaecology.

* Human Reproduction – Full Title: First Reported Clinical Pregnancy Following Heterotopic Grafting of Cryopreserved Ovarian Tissue in a Woman after a Bilateral Oophorectomy. (doi:10.1093/humrep/det360