Fertility Preservation Options for Females with Turner Syndrome Are Growing: A new article by Dr. Oktay and colleagues reviews options and provides guidelines.
Turner Syndrome is a common genetic condition which is encountered in 1 in 2000 individuals. In general, the partial or complete absence of one X chromosome in or all or some of the body cells can lead to a number of developmental problems one of which is very high risk of premature ovarian failure. Over 90% of all girls with Turner Syndrome exhaust all their eggs by the time they reach puberty. Most others will lose their fertility by the time they reach adult age.
Until recently, there was no option for children with Turner Syndrome to preserve their future fertility. However within the recent years, we developed approaches that can be used in children to preserve fertility.
One of these approaches is ovarian tissue freezing which requires an outpatient laparoscopic procedure. Though this procedure is still considered experimental, in adults, over one third of all females who have cryopreserved their ovarian tissue before chemotherapy were able to have at least one child (Oktay et al American Journal of Obstetrics & Gynecology, 2015).
Another approach also reported by us recently is cryopreservation of oocytes from postpubertal children. We showed that in selective female children of as young as 13 years of age, egg retrievals can safely be performed (Oktay et al, Journal of Pediatric and Adolescent Gynecology, 2014).
In some very young prepubertal girls who have not yet shown significant ovarian reserve loss, we also developed a monitoring approach, which may allow us to intervene when it is absolutely necessary. That strategy is useful in allowing further development of small children so that for example, instead of experimental ovarian tissue freezing, more established egg freezing procedures can be performed at a later age.
Dr. Oktay recently chaired a group of experts under the auspices of the Turner Syndrome Foundation, which published its findings in the form of practical guidelines for preserving fertility in females with Turner Syndrome. This document reviews all fertility preservation strategies and fertility in girls with Turner syndrome can be freely accessed here.
Turner Syndrome Foundation press release can also be found here.
Study Records First-Ever Successful Pregnancies with New Ovarian Transplant Surgery in Two Tri-State Area Women.
Valhalla, NY – Women who may be at risk for losing their fertility due to cancer treatments are now able to conceive with their own frozen ovarian tissue and carry a baby to term with greater success using a newly-enhanced, robot-assisted surgical ovarian transplantation technique, according to a study released today in the American Journal of Obstetrics & Gynecology. Short-titled Improving Ovarian Transplantation Success, the study spanned 14 years and represents the outcomes of ovarian cryopreservation and transplantation research in two tri-state area patients.
Led by Kutluk Oktay, M.D., Ph.D., who is a professor of Obstetrics and Gynecology of the School of Medicine at New York Medical College (NYMC) and a world-renown infertility specialist who developed the first ovarian transplantation procedures, the study is the first-ever published report of a live birth and pregnancies derived from the multipronged technique, which combines auto transplantation of frozen-thawed ovarian tissue with robot-assisted surgery and the utility of AlloDerm, a decellularized human extracellular tissue matrix (ECTM) generated from cadaver skin.
“Ovarian tissue cryopreservation is evolving as an effective fertility preservation approach,” said Dr. Oktay. “While the quest for improving ovarian transplant techniques and outcomes is continuing, this study shows a marked improvement in achieving robust and reproducible results, giving new hope to many families struggling with cancer-treatment induced infertility.”
“Dr. Oktay’s work underscores the importance of pursuing research in developing medical specialties, like fertility preservation,” said D. Douglas Miller, M.D., C.M., M.B.A., dean of the School of Medicine. “New York Medical College is proud to be a leader in medical research, education and progress, which has once again been demonstrated by the breakthrough live birth and pregnancies recorded in this study.”
Patients Lauren Heuchling and Rosaria Usini Ruttenber, who had been diagnosed with a blood disorder and Hodgkin’s Lymphoma respectively, underwent ovarian tissue cryopreservation by Dr. Oktay at the age of 23 to preserve their fertility prior to receiving chemotherapy in preparation for hematopoietic stem cell transplantation.
Having been cured of their conditions, both patients underwent a robotically-assisted procedure, which was developed and performed by Dr. Oktay and his team of specialists, at seven years (Ms. Heuchling) and 12 years (Ms. Usini Ruttenber) after their ovarian tissues had been frozen. Although both patients became menopausal shortly after the completion of cancer treatments, the transplants reversed menopause within the three months after the Alloderm grafting. Both patients had subsequently conceived with in vitro fertilization. Ms. Usini Ruttenber has already delivered a healthy girl, who is now 4-months-old, and Ms. Heuchling, is presently 23 weeks pregnant.
Both patients have numerous frozen embryos generated from the transplanted frozen-thawed ovarian tissue, which they may use for future pregnancy attempts. Dr. Oktay and his team of researchers plan to assess the technique’s success in larger trials, which are approved by the New York Medical College Institutional Review Board.
"I feel so blessed to have had the opportunity to be a part of Dr. Oktay’s amazing, groundbreaking procedure,” said Lauren Heuchling. “Ovarian tissue cryopreservation and transplantation was my only option after being diagnosed with a rare blood disease at a very young age. I am so grateful to Dr. Oktay for always being positive and giving me hope that one day I would be able to have a biological child of my own. It may have been a long journey, but I have him to thank for this miracle and for making my dreams come true." "At the age of 23, after learning that my cancer was back, I was told that I would have to undergo a stem cell transplant, which would most likely leave me infertile,” said Rosaria Usini Ruttenber. “Coming from a large Italian family where family is everything, I was devastated by the news that I may not be able to have children, something I so desperately wanted. However, thanks to Dr. Oktay, my hope was restored, and now my husband and I have a beautiful, healthy baby girl. Giuliana Hope Ruttenber is truly a miracle, and seeing her smile everyday makes it all worth it!"
To access the full study, please click here: http://www.ajog.org/.
Dr Oktay speaks on Fertility Preservation on women with breast cancer, Toronto, Canada.
Jun 10, 2015, 12:31 PM ET (By GILLIAN MOHNEY) A 27-year-old Belgian woman, who was left infertile after chemotherapy, was able to give birth to a healthy baby boy thanks to a groundbreaking procedure that utilized her ovarian tissue frozen 14 years ago. Read more...
May 7, 2015 by Alice Park (TIME) - This newborn is the first baby in the world born using a breakthrough IVF treatment... Because the procedure is so new, some reproductive science experts are skeptical. What’s lacking, they say, is convincing evidence comparing pregnancy rates of women undergoing Augment to those with similar infertility problems who didn’t use the technique. So far, no formal clinical trials have been conducted; the only data on the procedure comes from recent presentations by Dr. Robert Casper of University of Toronto and Dr. Kutluk Oktay from Gen-ART IVF in Ankara, Turkey, both of whom are advisors to OvaScience.
Read more at http://time.com/3849127/baby-stem-cells-augment-ivf/
Oct 17, 2014 by Jillian Berman, Huffington Post. - Apple and Amazon covers egg freezing, Dr. Oktay interviewed.....
"Most women who want elective egg freezing present themselves at not an ideal age," said Dr. Kutluk Oktay, a professor of obstetrics and gynecology at New York Medical College who is a co-author of an analysis of several studies that included 1,805 patients who froze their eggs.
Still, that hasn't stopped the media, egg-freezing startups, fertility clinics and now implicitly Facebook and Apple from touting egg freezing as a remedy for women who don't want to take time out of an ascendant career to start a family.
May 20 , 2013 by: ASRM Office of Public Affairs, Published in ASRM Press Release. For the first time, in Fertility and Sterility, researchers present age-specific probabilities of live birth after IVF with frozen eggs. Read complete article at ASRM...