NYU Winthrop Hospital today announced that Kutluk Oktay, MD, PhD, the world’s leading expert in fertility preservation, performed Long Island’s first-ever ovarian transplant at the hospital, giving new hope to a leukemia survivor that she might someday bear children. The procedure, performed on a 26-year-old woman, replaced ovarian tissue that had been surgically removed from her at age 15, prior to radiation therapy for a bone marrow transplant. Dr. Oktay pioneered ovarian transplants in 1999, but there remain only a dozen or so experts in the world versed in such transplants. Dr. Oktay achieved another innovation with the NYU Winthrop Hospital procedure, utilizing the da Vinci® robot to assist with the surgery, thereby optimizing both the precision of the procedure and likelihood of a successful patient outcome.
“The ovarian transplant that I pioneered should be presented as a medical option for any young girl or woman who risks losing her fertility due to chemotherapy or radiation treatments,” said Kutluk Oktay, MD, PhD, an attending physician at NYU Winthrop Hospital and the director of the 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 girl never having the chance to bear her own children.”
Dr. Oktay, who is also a professor of obstetrics, gynecology, and reproductive sciences at Yale University School of Medicine, noted that the removal of a girl’s ovary is a simple procedure that can be done at any age; he has performed the procedure on children as young as one year of age. In the ovarian tissue harvesting procedure, one ovary is removed, and slivers of the ovarian tissue are preserved with a cryoprotective agent and then frozen with an automated machine. The tissue is then stored at a temperature of minus 270 degrees Celsius (about minus 518 degrees Fahrenheit), with no time limit for storage. Later, following remission of cancer, the tissue can be transplanted back into a woman to restore fertility. In that procedure, approximately 15 to 20 slivers of ovarian tissue are thawed and grafted on to the woman’s remaining ovary, with that transplanted tissue connected to existing ovary blood vessels.
“The existing ovary serves as a type of dock, opening up a vascular platform where the thawed tissue can be attached,” added Dr. Oktay. “The robotic arms then assist the surgeon in suturing and rejoining old and new tissue together, creating a new hybrid ovary.”
In addition, Dr. Oktay developed a modified procedure for patients who cannot tolerate surgery, which involves grafting the ovarian tissue under the abdominal skin.
The NYU Winthrop patient involved in the latest procedure suffered from leukemia 3 times as a child, at ages 3, 8, and then 15. In the last instance, she had to be induced into a month-long coma as cancer cells swelled her brain. Prior to beginning radiation treatments for a bone marrow transplant, the girl’s parents reached out to Dr. Oktay, and 72 hours later, she underwent an ovary removal. Now married and looking forward to starting a family, the patient, who prefers to remain anonymous at this time, said, “This procedure is literally life-changing. I now have the chance to have my own children.”
It will take three to six months before the success of the patient’s transplant will be fully determined, though initial follow-up showed great promise with strong blood flow from the new vascular platform into the new ovary upon radiological examination.
Rosaria Ruttenber, age 39, knows well the promise of this procedure. The Norwalk, CT, resident had suffered from Hodgkin’s disease, a cancer of the lymphatic tissue. Before undergoing a stem cell transplant at age 23, Dr. Oktay removed one of her ovaries and cryopreserved it. Sixteen years later, Dr. Oktay transplanted her ovarian tissue. The transplant was a success and her daughter, Giuliana, was born in 2015. The family now hopes to have another child in the near future.