Abstract
To report the long-term follow-up of an experimental heterotopic ovarian transplantation with frozen-thawed ovarian tissue. Long-term follow-up of an experimental surgery; case report. Academic reproductive medicine center. A 28-year-old cancer survivor with previous Hodgkin disease and relapse. Laparoscopic oophorectomy for ovarian cryopreservation before preconditioning chemotherapy for hematologic stem cell transplantation. Ovarian tissue thawing and subcutaneous heterotopic ovarian transplantation in the lower abdominal wall 2½ years after the hematologic stem cell transplantation. Resumption of ovarian function after transplantation, recovery of fertility, and pregnancy outcome. Follicle development was observed in the graft 2 months after transplantation, and a P value of 14 ng/mL indicated ovulation. The patient conceived spontaneously four times within 5 years and delivered three children. The in situ ovary remained atrophic but showed occasional follicle activity contemporaneously with the graft. The mechanism behind spontaneous restoration of fertility with consecutive viable pregnancies after a heterotopic ovarian transplantation needs to be explored. Further laboratory and clinical research will be needed to explore the true origin of pregnancies after ovarian transplantations.
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