A Florida resident faced 3 battles with leukemia during her childhood, at ages 3, 8, and 15. As a teen, she spent one month in an induced coma as cancer cells swelled her brain. Prior to beginning radiation treatments for a bone marrow transplant in 2007, the girl’s parents sought out infertility and preservation specialist, Kutluk Oktay, MD. Just 72 hours later, she underwent ovary removal surgery.
In 2017 at NYU Winthrop Hospital, the girl’s ovarian tissue, which had been frozen and preserved, was transplanted back into the now-married woman by Dr. Oktay. “This procedure is literally life-changing. I now have the chance to have my own children,” explains the patient.
Dr. Oktay, a world-renowned pioneer in fertility preservation, is one of a small group of experts well-versed in such procedures. The transplant performed at NYU Winthrop marked Long Island’s first-ever ovarian transplant, and the first time the da Vinci® surgical system was used for the procedure. Dr. Oktay guided the four robotic arms in the intricate process from a console where he viewed a high-definition, three-dimensional image of the surgery area, optimizing both the precision and likelihood of a successful patient outcome.
“The ovarian transplant should be presented as a medical option for any young girl or woman who risks losing her fertility due to chemotherapy or radiation treatments,” says Dr. Oktay, an attending physician at NYU Winthrop Hospital and director of its Ovarian Transplant Program. “An ovarian transplant should be viewed in disciplines such as oncology as preventative care, since the procedure can prevent the loss of fertility. Diseases such as cancer are devastating enough when occurring in children, let alone when a family is faced with the prospects of their daughter never having the chance to bear her own children.”
Dr. Oktay notes that ovary removal is a simple procedure that can be done at any age, and that he once had a 1-year-old patient. During the process, one ovary is removed, and slivers of the ovarian tissue are preserved with a cryoprotective agent then frozen with an automated machine. The tissue is then stored at a temperature of approximately minus 321 degrees Fahrenheit, with no expiration on storage.
Following remission of cancer, the tissue can be transplanted back into a woman to restore fertility using minimally invasive robotic surgery. Approximately 15 to 20 slivers of ovarian tissue are thawed, and grafted onto the woman’s remaining ovary, with that transplanted tissue connected to existing ovary blood vessels. The robotic arms assist the surgeon in suturing, and rejoining old and new tissue together, creating a new hybrid ovary. Dr. Oktay also developed a modified procedure for patients who cannot undergo surgery which involves grafting ovarian tissue under the abdominal skin.
To date, it’s estimated that more than 90 children have been born thanks to fertility preservation, and successful ovarian transplants.
