Breaking News
February 21, 2018 - Household Products May Pollute the Air as Much as Your Car Does: Study
February 21, 2018 - Combo Bests Targeted Agent in mRCC
February 21, 2018 - Researchers discover brain pathway that dissociates opioid addiction from analgesia
February 21, 2018 - Scientists uncover how newly discovered gene helps grow blood vessels
February 21, 2018 - Brain’s quality control process holds clues to obesity’s roots
February 21, 2018 - Researchers to study whether menstrual cups can help prevent vaginal infections
February 21, 2018 - MS patients who feel stigmatized more likely to suffer from depression
February 21, 2018 - Vitamin D supplementation during pregnancy could protect against childhood obesity
February 21, 2018 - Lower-Quality Medical Tx Might Have Skewed Key PCI vs CABG Trials
February 21, 2018 - Love and fear are visible across the brain instead of being restricted to any brain region
February 21, 2018 - Adults with congenital heart disease have increased risk for dementia, study finds
February 21, 2018 - Clinical trial studying type 1 diabetes reaches full enrollment
February 21, 2018 - Father’s stress affects the brain development of offspring, mice study shows
February 21, 2018 - ESRD Death Declines in Vasculitis Patients
February 21, 2018 - Taking ibuprofen for long periods found to alter human testicular physiology
February 21, 2018 - Google AI device could predict a person’s risk of a heart attack
February 20, 2018 - FDA Approves Domestic Source for Tc-99m Isotopes
February 20, 2018 - Sanofi rejects refund demand faces Philippine suit over dengue vaccine (Update)
February 20, 2018 - Researchers discover that activation of specific enzyme may help suppress tumor metastasis
February 20, 2018 - Blood or marrow transplantation survivors have higher risk of cognitive impairment
February 20, 2018 - Booze Beats Pot at Being Unhealthy: Oregon Poll
February 20, 2018 - Morning Break: ’20 Years Late’; Drugs in the Dirt; Catching Flu in the Dorm
February 20, 2018 - Another piece to the puzzle in naked mole rats’ long, cancer-free life
February 20, 2018 - Scientists identify four viruses that can produce insulin-like hormones
February 20, 2018 - New e-Health solution developed to prevent cardiovascular disease, dementia in senior citizens
February 20, 2018 - New genetic risk score could help guide screening decisions for prostate cancer
February 20, 2018 - Study finds higher risk of stroke among blacks with atrial fibrillation than whites
February 20, 2018 - Physical activity could be used as strategy for diabetes prevention
February 20, 2018 - Researchers develop sensing method for early detection of cancer and diabetes
February 20, 2018 - New wearable electronics could be game-changer for stroke rehabilitation
February 20, 2018 - Immune history influences person’s response to flu vaccine
February 20, 2018 - Research findings could help develop new drugs to prevent, treat dry eye disease
February 20, 2018 - Serenity Now! Learn to Have Patience with Patients
February 20, 2018 - Computer simulation addresses the problem of blood clotting
February 20, 2018 - Women with type 1 diabetes not protected against coronary artery disease
February 20, 2018 - Persistent bloating can be a sign of ovarian cancer, warns charity
February 20, 2018 - Trump administration proposes rule to loosen curbs on short-term health plans
February 20, 2018 - Key protein involved in epigenetic regulation of gene expression guides skin cell renewal
February 20, 2018 - Heart attack symptoms often missed in women
February 20, 2018 - Diagnosis of celiac disease takes 3.5 years for patients who do not report GI symptoms
February 20, 2018 - Study reveals functional dynamics of ion channels
February 20, 2018 - Study explores link between mortality risk and combustible tobacco use
February 20, 2018 - ‘She Trusted Me, and I’d Turned Her Away’
February 20, 2018 - AbbVie and Voyager Therapeutics collaborate to develop new treatments for tauopathies
February 20, 2018 - Fast food makes the immune system more aggressive in the long term
February 20, 2018 - Therapeutic target for glaucoma could have treatment ramifications for Alzheimer’s and Parkinson’s
February 20, 2018 - Overcoming Negative Reviews | Medpage Today
February 20, 2018 - MyD88—villain of allergies and asthma
February 20, 2018 - Food scientists develop rapid screening technique to detect pesticide residue in vegetables
February 20, 2018 - Lab-grown cerebellar cells may help explain how ASD develops at molecular level
February 20, 2018 - Scientists explore connection between bad sleep habits and stiff blood vessels
February 20, 2018 - New Treatment Apalutamide (Erleada) Approved for Prostate Cancer That Resists Hormone Therapy
February 20, 2018 - Do You Really Need My Signature on That?
February 20, 2018 - HIV-1 genetic diversity is higher in vaginal tract than in blood during early infection
February 20, 2018 - Diabetes does not increase work-loss years due to early retirement
February 20, 2018 - Researchers aim to find out how PTSD affects decisions of police
February 20, 2018 - UH Cleveland Medical Center explores novel treatments for uterine fibroids
February 20, 2018 - Flu Vax Efficacy 25% Against Predominant H3N2 Strain So Far
February 20, 2018 - HIV screening most optimal at 25 years of age if no risk factors
February 20, 2018 - Loyola Medicine primary care physician offers advice to minimize risk of flu
February 20, 2018 - Safe sleep recommendations for parents that may help reduce child’s risk of SUID
February 20, 2018 - Why Do So Few Docs Have Buprenorphine Waivers?
February 20, 2018 - Low levels of alcohol good for the brain
February 20, 2018 - Experimental treatment improves invisible symptoms of a man with spinal cord injury
February 20, 2018 - Myriad’s EndoPredict offers better prediction of breast cancer recurrence, analysis shows
February 20, 2018 - Researchers identify fifteen genes that determine our facial features
February 20, 2018 - Morning Break: New Health IT Player; Luxturna No Bargain; Nuclear Freakout
February 20, 2018 - How does it compare? Hospice care at home, at assisted living facility, at nursing home
February 19, 2018 - Scientists develop water-soluble warped nanographene for bioimaging
February 19, 2018 - It’s Not Your Imagination: You’re Hungrier After Losing Weight
February 19, 2018 - Antihypertensive Use At Delivery Rising in Preeclampsia
February 19, 2018 - A centuries-old math equation used to solve a modern-day genetics challenge
February 19, 2018 - Liquid biopsies could be used as new predictive marker for metastatic TNBC
February 19, 2018 - Russian researchers develop new multi-layered biodegradable scaffolds
February 19, 2018 - Are ‘Vaccine Skeptics’ Responsible for Flu Deaths?
February 19, 2018 - Hidden genetic effects behind immune diseases may be missed, study suggests
February 19, 2018 - Emergency nurses experience regular verbal and physical abuse
February 19, 2018 - Study sheds light on biology that guides behavior across different stages of life
February 19, 2018 - Morning Break: Transgender Breast Feeding; Brazilian ‘Pro-Vaxxers’; Post-Stroke Exercise
February 19, 2018 - Meningitis vaccination strategy in Africa found to be effective, economical
Transplant of ovarian tissue frozen years ago holds hope of life

Transplant of ovarian tissue frozen years ago holds hope of life

image_pdfDownload PDFimage_print
Credit: CC0 Public Domain

Ovarian tissue that was frozen a decade ago was implanted last week in a 25-year-old cancer survivor who hopes that reviving the tissue from suspended animation will allow her to start a family.

The procedure – which involves myriad disciplines in medicine, cell biology and surgery – is known as an ovarian transplant and was performed at NYU Winthrop Hospital in Mineola, marking a series of “firsts.”

It was the first ovarian transplant on Long Island, the first performed anywhere on an outpatient basis and the first such transplant to involve a surgical robot.

A team accomplished the two-hour procedure recently, led by Dr. Kutluk Oktay, the surgeon-scientist who was the first in the world to perform the technique nearly two decades ago at New York Methodist Hospital in Brooklyn, now part of the NewYork-Presbyterian Regional Hospital network. This time around, the multi-armed Da Vinci surgical robot was instrumental in the transplant.

“I developed the procedure and my first case was in 1999; it was published in the New England Journal of Medicine,” said Oktay, an attending physician at NYU Winthrop and a leading expert in the field of fertility preservation. He also is a professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine.

He studied with scientific teams in this country and abroad to create a method of preserving fertility for young women diagnosed with cancer and at risk of never having children. Harsh cancer therapies induce menopause, and hence infertility.

The good news: About 90 babies have been born via ovarian transplants since the early 2000s.

Oktay’s patient at NYU Winthrop, whom he has known since 2007, did not want to disclose her name. But she gave her doctor permission to convey highlights of her long and arduous medical journey.

“She was diagnosed with leukemia when she was 15, which required a bone marrow transplant. Patients receive huge doses of chemo and radiation, which can wipe out all of the eggs,” Oktay said. “Prior to her leukemia treatment, I removed one of her ovaries, which contained all of the immature eggs at that time.”

Ovaries are twin reproductive organs, each about the size of a walnut, that produce ova, or egg cells. Each egg cell possesses 23 chromosomes, which is the maternal half of a baby’s full genetic dowry of 46. Each parent donates 23 at the moment of conception.

In 2007, key portions of the patient’s surgically removed ovary were finely cut into what the doctor described as 15 to 20 “slivers” – super-thin grafts of ovarian tissue that were preserved by freezing .

Each graft, Oktay explained, was treated with the cryoprotective agent dimethyl sulfoxide, or DMSO, which prevents crystal formation in cells. Left untreated, ice crystals would form and puncture the cells, rendering them useless.

“You don’t want to freeze the whole ovary,” Oktay said. “The immature eggs are on the surface, so we peel off that layer. This is what we cut into tiny slivers.”

Each sliver was placed in small vials about the size of a lipstick tube and then into canisters that were placed in a liquid nitrogen chamber. The temperature can be dropped to an otherworldly minus 140 degrees Celsius, which is about minus 220 degrees Fahrenheit, nearly as cold as the surface of Jupiter.

“We use a program of slow-freezing, slowly bringing down the temperature,” Oktay said. “We use slow freezing so there is no shock to the cells.”

The cryopreserved specimens can remain indefinitely in a state of suspended animation and thawed when women are ready for them. The grafts were stored at Manhattan CryoBank, a cell and tissue repository.

Oktay’s patient contacted him recently to begin the process, which is geared toward restoring ovulation and the flow of reproductive hormones.

“She has gotten married and wants to start a family,” Oktay said. “So we are trying to help her.”

For Oktay, perfecting a method to preserve fertility for women who have had cancer is the result of years of effort. He studied with researchers in Britain before working with patients in Brooklyn, and also while on staff at Weill Cornell Medical Center in Manhattan.

Adding the Da Vinci robot to the procedure is new and allows the tissue grafts to be introduced into the patient through a smaller incision via the robot’s tiny “hands.” Oktay implanted about 14 of the preserved grafts into his patient’s remaining, menopausal ovary.

Fertility doctors worldwide have long suggested that the technique has possibilities for women with other medical conditions that have debilitating therapies, or for women who want to postpone childbirth.

Rosaria Ruttenber, 39, who was treated twice for Hodgkin’s disease, a cancer of the lymphatic tissue, said ovarian transplantation worked perfectly. Her daughter, Juliana, was born in 2014.

Ruttenber, who lives in Norwalk, Connecticut, said her right ovary was removed 16 years ago and cryopreserved before she underwent cancer treatment when she was 23. Through in vitro fertilization, her preserved eggs were merged with her husband’s sperm. The couple now has seven cryopreserved embryos.

“It has been a long road and well worth it. Looking back, I am glad we did it,” said Ruttenber, who is looking forward to trying for a second child.


Explore further:
Is ‘ovarian tissue freezing’ superior to egg freezing?

Journal reference:
New England Journal of Medicine

Tagged with:

About author

Related Articles