Explainer: Ovarian cortex transplant

Ovarian cortex transplant offers a glimmer of hope to women with fertility challenges after being diagnosed with cancer. We explore the risks, benefits, and potential outcomes of this groundbreaking new treatment.

Australia first ovarian tissue transplant was carried out at the Epworth Hospital.

As medical science continues to advance, new treatments and procedures are emerging that offer hope to women facing fertility challenges. One such procedure is ovarian cortex transplants, which involves the removal and restoration of ovarian tissue.

This innovative approach can help women who have lost ovarian function due to cancer treatment, genetic conditions, or other factors, to restore their fertility and potentially improve their quality of life.

In this explainer, we explore the intricacies of ovarian cortex transplant, including the risks, benefits, and potential outcomes.

What is the ovarian cortex?

The ovarian cortex is the outer portion of the ovary. The ovarian follicles are located within the ovarian cortex.

How is the transplant performed?

The ovarian cortex is first removed through a laparoscopic (keyhole) surgery. This outer layer contains hundreds to thousands of eggs that can potentially continue to grow once the tissue is returned. The amount of tissue that is taken depends on the specific patient and this is a day procedure. The tissue is then processed and frozen in liquid nitrogen, where it can be safely stored for many years.

Once the woman is ready to start a family of her own, the ovarian cortex (egg producing area) is thawed and assessed for viability and any concerning tissue, such as cancer cells. The graft, usually only a couple of square centimetres in size, is then can be returned to the woman’s body through a laparoscopic procedure – most commonly, sewn back into her remaining ovary, but also potentially into other accessible areas.

Are there any risks associated with the initial and subsequent surgery?

The surgical procedures are very much like any other gynaecological laparoscopic procedure and are considered to be low risk.

How many times has the procedure been successfully performed (Australia/worldwide):

There have only been a dozen pregnancies following transplantation in Australia, including this first one in Queensland, and just over one hundred worldwide.

When is the procedure used:

This procedure can only be used if there is normal ovarian function at the time of the cortex collection.

It is used primarily for women who are experiencing ovarian failure or premature menopause as a result of chemotherapy that damages the ovary.

What are the chances of success?

If the ovarian cortex was taken from a young woman, the chances of having a baby have been reported at more than 50%

How soon after transplantation does ovarian function return?

Approximately 5 months

Who would be a primary candidate for this surgery?

The treatment is suitable for relatively young patients with ovarian failure who have ovarian cortex stored prior to chemotherapy.

What factors would make a patient ineligible for this surgery?

Patients who have cancers that may be returned to the patient through the graft, such as ovarian cancers.

Can the patient expect to fully regain their fertility after undergoing the transplantation procedure?

No – the graft is only likely to work for a limited period of time

In cases where a woman undergoes the procedure due to cancer, is there a risk of transmitting the cancer to the unborn child?

No – this is part of the screening test and why some patients are ineligible to have a transplant