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Hum. Reprod. Advance Access first published online on April 3, 2006
This version published online on April 19, 2006
Human Reproduction, doi:10.1093/humrep/del092
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received December 12, 2005
Revised February 27, 2006
Accepted March 2, 2006

Case Report

Ovarian function and spontaneous pregnancy after combined heterotopic and orthotopic cryopreserved ovarian tissue transplantation in a patient previously treated with bone marrow transplantation: Case Report

Isabelle Demeestere 1 *, Philippe Simon 2, Frédéric Buxant 2, Valérie Robin 3, Sergio Fernandez-Aguilar 4, Julie Centner 5, Anne Delbaere 1, and Yvon Englert 1

1 Research Laboratory on Human Reproduction; Department of Obstetrics and Gynaecology, French Speaking Free University of Brussels (ULB), Erasme Hospital, Brussels, Belgium
2 Department of Obstetrics and Gynaecology, French Speaking Free University of Brussels (ULB), Erasme Hospital, Brussels, Belgium
3 Department of Haematology, French Speaking Free University of Brussels (ULB), Erasme Hospital, Brussels, Belgium
4 Department of Pathology, French Speaking Free University of Brussels (ULB), Erasme Hospital, Brussels, Belgium
5 Research Laboratory on Human Reproduction, French Speaking Free University of Brussels (ULB), Erasme Hospital, Brussels, Belgium

* To whom correspondence should be addressed.
Isabelle Demeestere, E-mail: idemeest{at}ulb.ac.be


  Abstract

Cryopreservation of ovarian tissue has been proposed for storing gametes of young patients at high risk of premature ovarian failure. Autotransplantation has recently provided some promising results and is still the unique option to restore ovarian function from cryopreserved ovarian tissue in humans. In this article, we analyse data from the combined orthotopic and heterotopic transplantation of cryopreserved ovarian tissue that restored the ovarian function and fertility. Orthotopic transplantation of cryopreserved ovarian tissue at ovarian and peritoneal sites, together with a heterotopic transplantation at the abdominal subcutaneous site, was performed to restore the ovarian function of a 29-year-old woman previously treated with bone marrow transplantation (BMT) for Hodgkin’s disease. Ovarian reserve markers progressively suppress within values 5 months after the transplantation (basal FSH 5 mUI/ml and inhibin B 119 ng/ml). Follicular development was observed at all transplantation sites but was predominant at the ovarian site. Six natural cycles were fully documented and analysed. The patient became spontaneously pregnant following the sixth cycle, but unfortunately she later miscarried. Combined orthotopic and heterotopic transplantations succeeded in the restoration of normal spontaneous cycles. Furthermore, this spontaneous pregnancy confirmed the efficiency of this procedure for restoring human fertility.

Keywords: cancer/cryopreservation/ovarian tissue/pregnancy/transplantation.
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