Fertility hope for cancer victims
As woman hopes to have baby after frozen ovary is re-implanted
A woman hopes to be the first to become pregnant after having an ovary removed as an eight-year-old and then re-implanted.
Moaza Alnatrooshi, 23, had one of her ovaries removed and frozen before undergoing chemotherapy.
If an embryo is implanted successfully next month, she will be the first woman to become pregnant after having her ovary frozen well before puberty.
The news gives hope to thousands of girls whose treatment for cancer and other diseases could damage their reproductive organs.
Mrs. Alnatrooshi had the ovary frozen before she was treated for beta thalassaemia, which is an inherited blood disorder, at Great Ormond Street Hospital in London.
She needed chemotherapy, which damages the ovaries, before a bone marrow transplant from her brother.
Fearing her daughter would never be able to conceive, her mother investigated methods of saving her fertility.
She decided to have her daughter’s ovary removed before the treatment and frozen at a specialist centre in Leeds.
Mrs. Alnatrooshi’s remaining ovary had been left only partially functioning after treatment and, at the age of 21, she suffered an early menopause.
Last year, doctors arranged for the frozen ovary to be transported to Denmark, where the transplant took place.
The ovarian tissue was re-implanted last August, with Dr. Sara Matthews, who is a consultant gynaecologist at the private Portland Hospital for women and children in London, assisting the Danish doctors who have pioneered ovary freezing and transplantation.
After the operation, Mrs. Alnatrooshi’s hormones returned to normal levels and she and her husband Ahmed underwent In Vitro Fertilisation (IVF) treatment to increase their chance of pregnancy.
Eight eggs were collected and three embryos have been produced.
The embryos were frozen and Mrs. Alnatrooshi is expected to have one of them implanted next month.
According to the UK’s Human Fertilisation and Embryology Unit, only a small number of babies, less than 20, have been born worldwide following transplantation of frozen-thawed ovarian tissue and no pregnancies have resulted from whole ovary transplants.
Doctors are confident that, because of her young age, it will be successful and she will become pregnant.
Mrs. Alnatrooshi, who is from Dubai, told the Sunday Times: ‘There is nothing that makes me happier than using my own ovary. My mum did this huge thing for me, which is that she froze my ovary and saved it for me until I grew up and used it.
“I am so happy that Dr. Matthews got eight eggs. I have hope. I want to believe I will be pregnant. I cannot wait for that day.
I would like to say to all women that they have got to have hope.”
Matthews said: “This allows young girls who develop cancer or have other conditions that require chemotherapy, like beta thalassaemia, to have children where the vast majority, over 90 per cent, would not be able to have their own children. There is no other way at the moment to do it.
“You cannot grow eggs. You can’t do IVF (before the chemotherapy) because they haven’t gone through puberty.
“It is the only option for them and we have been able to prove that, in practice, it works.”
Prof. Claus Yding Andersen of Copenhagen University, who organised Mrs. Alnatrooshi’s operation in Denmark, said: “If Moaza becomes pregnant this will be the first pregnancy where eggs were derived from ovarian tissue removed at an early age, prior to puberty.
“Just the fact that such eggs can be fertilised successfully raises hope for the many young girls who will, unfortunately, experience childhood cancer. Hopefully, this case will lead to the more widespread use of this procedure in the UK.”
St George’s Hospital in South West London is preparing to offer ovary freezing in a collaboration with Prof. Yding Andersen.
His team will travel to London to carry out freezing and storage. Dr. Gedis Grudzinskas, who is on the steering committee of the PreFer service at St George’s Hospital, said: “This gives realistic hope to thousands of women in the UK.”
In November 2014, a woman gave birth after having her ovarian tissue removed as a 13-year-old and later re-implanted.
The woman, who was treated in Belgium, had the tissue removed after suffering sickle cell anaemia. Aged 28 she had a healthy boy and doctors said there was no reason she could not go on to have further children.
• Adapted from The Sunday Times
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