Catalan doctors help a patient become the first woman in the world with no ovaries to get pregnant

Sant Joan de Déu Hospital in Greater Barcelona has become the first facility in the world to assist a woman who lost her two ovaries to get pregnant. A decade ago she had to have her ovaries completely removed because of two tumours. Ovarian tissue was frozen, kept for ten years and now re-implanted. The patient has had her period again and, thanks to in vitro fertilisation, is now pregnant.

CNA / Bertran Cazorla

December 16, 2011 07:17 PM

Esplugues de Llobregat (ACN). - Ten years ago a twenty-year-old Catalan woman lost her two ovaries because of two tumours. Four days ago, the same woman underwent an ultrasound scan and inside her womb she could hear the heartbeat of her son. She is the first woman in the world to become pregnant after having lost her two ovaries. This great advancement has been achieved thanks to the gynaecologists at Sant Joan de Déu Hospital in Esplugues de Llobregat, in Greater Barcelona. When the organs were extracted, ovarian tissue was kept frozen for ten years at the blood and tissue bank. Thirteen other women around the world were able to give birth after undergoing oncology treatment for their ovaries and self transplants, but they did not have both organs totally removed. Until now no woman without ovaries has been able to get pregnant.

In a developed area of the world like Catalonia between 70% and 80% of women who find an ovarian tumour survive. Oncology treatment, however, is usually aggressive with reproductive organs and, therefore, surviving the tumour leads to fertility problems. This is one of the reasons why there is a great drive to try to grant these women the possibility of becoming mothers if they want to, explained Justo Callejo, Clinical Head of the Gynaecology and Obstetrics Service at the Maternity and Children’s Hospital Sant Joan de Déu, in Esplugues de Llobregat, in Greater Barcelona.

For the first time in the world, a woman without ovaries gets pregnant

A team led by Dr. Callejo has made a major advancement by succeeding in making a woman without ovaries pregnant, the first time this has happened in the world. It was possible through a method that had already been tested: the self transplant of ovarian  tissue that had been extracted from the woman for preservation before the aggressive oncological treatment began. However, never before had a woman without her two ovaries managed to get pregnant.

Thirteen women have been able to have children thanks to this self-transplant technique, one of them in Valencia. If the Catalan woman’s child is born next summer, it will be the fourteenth time that the treatment has been successful. But she will be the first example of a patient in the world to achieve it after having lost both ovaries.

The patient lost her two ovaries in 2000 because of two tumours

The patient had her two ovaries removed in 2000, when she was 20 years old. She was diagnosed with ovarian cancer: a tumour in one ovary, and then another tumour in the other. When doctors removed the organs, however, they preserved some healthy parts and kept it for a decade at the Blood and Tissue Bank of Catalonia and the Balearic Islands. Last March, the woman, now 31 years old and with a partner, went to the hospital because she wanted to get pregnant.

The preserved ovarian tissue was re-implanted

Last June, doctors from Sant Joan de Déu Hospital re-implanted the preserved tissue in the patient. They did it through an innovative technique, which consists of using certain growth elements from the patient’s blood. These facilitate the preserved and implanted tissue to connect up with the blood flow.

The ovaries get back to normal

The technique was a success and, last October, the patient started to have the first symptoms that self-transplanted ovarian tissue had begun to work. Some of the symptoms were the return of mammary swelling and vaginal flow. She also had her first period since 2000. Two ovules were fertilised through assisted reproduction and one of them survived. The embryo was implanted in the woman’s womb. Four days ago,  the Sant Joan de Déu medical team found the sound of a foetus heart beating inside the mother.

“This case is the only one with evidence that the pregnancy has come from the implanted ovary, because there were no other remains”, explained the Head of Gynaecology and Obstetrics at Sant Joan De Déu Hospital, Dr. Josep Maria Laila. Dr. Callejo stressed the advancement this case represents for medical research. 

The possibility to become a mother after having her ovaries totally removed

“At this hospital we now offer people that unfortunately have been diagnosed with a tumour at an early age, and want the option to become a mother” the possibility to try it, stated Lailla.

Treatment for young women

Treatment is designed for young women, even minors, who have had an ovarian tumour. They can delay the treatment to undergo surgery to remove healthy ovarian tissue. Currently, Sant Joan de Déu Hospital preserves ovary tissue remains from 173 patients with this profile at the Blood and Tissue Bank, in case they want to try to get pregnant in the future. However, none of them had totally lost their ovaries, as in this latest case.