26-Year-Old Woman Receives Ovary Back Following Removal at Age 15
A young girl from Florida suffered from leukemia three times as a child, at ages three, eight and then 15. In the last instance, she had to be induced into a month-long coma as cancer cells swelled her brain. Prior to beginning radiation treatments for a bone marrow transplant, however, the girl’s parents tracked down a pioneer in the preservation of fertility, Kutluk Oktay, MD, PhD. Just 72 hours later, the girl underwent an ovary removal. That was 11 years ago. This past November at NYU Winthrop Hospital, the girl’s ovarian tissue, which had been frozen and preserved, was transplanted back into the now-married woman, who said, “This procedure is literally life-changing. I now have the chance to have my own children.”
Kutluk Oktay, MD, PhD.
Dr. Oktay pioneered ovarian transplants, though there remain only a dozen or so experts in the world versed in such procedures. The transplant performed at NYU Winthrop marked Long Island’s first-ever ovarian transplant, and was noteworthy for another first – the first time the da Vinci Robot Xi assistance was used in this delicate surgery. From a console where he viewed a high-definition 3D image of the surgery area, Dr. Oktay guided the four arms of the robot in the intricate procedure. Utilizing the robot optimized both the precision of the procedure and likelihood of a successful patient outcome.
“The ovarian transplant should be presented as a medical option for any young girl or woman who risks losing her fertility due to chemotherapy or radiation treatments,” said Dr. Oktay, who is an Attending Physician at NYU Winthrop Hospital and the Director of the Ovarian Transplant Program. “An ovarian transplant should be viewed in disciplines such as oncology as preventative care, since the procedure can prevent the loss of fertility. Diseases such as cancer are devastating enough when occurring in children, let alone when a family is faced with the prospects of their girl never having the chance to bear her own children.”
Dr. Oktay, who is also a Professor of Obstetrics, Gynecology and Reproductive Sciences at Yale University School of Medicine, noted that the removal of a girl’s ovary is a simple procedure that can be done at any age; he has performed the procedure on children as young as one year of age. In the ovarian tissue harvesting procedure, one ovary is removed, and slivers of the ovarian tissue are preserved with a cryoprotective agent and then frozen with an automated machine. The tissue is then stored at a temperature of approximately minus -321 degrees Fahrenheit, with no time limit for storage.
Later, following remission of cancer, the tissue can be transplanted back into a woman to restore fertility. In that procedure, approximately 15 to 20 slivers of ovarian tissue are thawed and grafted on to the woman’s remaining ovary, with that transplanted tissue connected to existing ovary blood vessels. The robotic arms then assist the surgeon in suturing and rejoining old and new tissue together, creating a new hybrid ovary. In addition, Dr. Oktay developed a modified procedure for patients who cannot tolerate surgery, which involves grafting the ovarian tissue under the abdominal skin.
To date, it’s estimated that more than 90 children have been born to mothers following successful ovarian transplants.