Ovarian transplant surgery may help preserve fertility of cancer patients

SINGAPORE : An ovarian transplant surgery performed for the first time in Singapore may help to preserve the fertility of cancer patients.

The procedure — called the ovarian orthotopic transplant — takes a part of the ovary before its functions are damaged, and freezes it for several years.

It is then transplanted back to the same patient after her cancer is in remission.

Before starting on chemotherapy, the cancer patient undergoes a keyhole procedure to remove one of her ovaries.

In the laboratory, the ovary tissue is cut into small strips — no thicker than 1 millimetre.

This is to enable rapid restoration of blood supply post—transplant.

The strips are then frozen — in a method called cryopreservation — before the patient undergoes cancer treatment.

At the end of her treatment — usually between three and five years — the thawed strips of tissue are transplanted back into the patient’s body.

Singapore General Hospital (SGH) carried out the first transplant last year on a 40—year—old married woman who suffered from breast cancer.

Her ovarian tissues were transplanted back to her body three years after she was treated for cancer.

She resumed menstruation three months after the transplant, which means she could get pregnant.

Dr Yu Su Ling, director of the Centre for Assisted Reproduction at Singapore General Hospital, said: "When we actually do this transplant, the transplant can last a few years for the patients. And they still can get pregnant on their own. Whereas if they have only frozen eggs and frozen embryos, and if they don’t get pregnant, they don’t have another chance."

There are risks involved in the ovarian orthotopic transplant. Besides operational risks of bleeding and infection, there are also concerns that the patient’s disease has spread to her ovaries.

That is why doctors have said it is best to choose patients who are in the early stages of their condition.

Patients pay between S$1,600 and S$4,000 to remove the ovary, and S$1,800 to S$5,500 for the transplant surgery.

On top of that, they need to fork out about S$4,000 to freeze, store and thaw the tissues.

Patients could use Medisave to pay for both surgeries. Thirteen patients from SGH have had their ovaries frozen so far.

The procedure is not just for cancer patients, but for any condition that destroys the ovaries.

— CNA/ms