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• W4387396238 abstract "To determine whether we can safely and successfully transplant an ovary tissue allograft from a non-identical donor to her Turner’s syndrome sister, using an innovative and safe immunosuppression protocol. A 20 year-old woman with non-mosaic XO Turner’s syndrome was amenorrheic with AMH (Anti-Mullerian hormone) of 0.015 ng/mL, and FSH of 67 mIU/mL. Her 22 year-old sister already had two children, normal menses, and an AMH of 4.97. They were HLA identical but ABO incompatible. There were no other donors available. According to their religion, donor oocytes are not allowed, but ovary tissue transplant is allowed. The left ovary of the donor was removed and dissected. One third of the cortex was transplanted to the right streak ovary of the recipient and the remaining two-thirds were cryopreserved. The immunosuppression protocol consisted of methylprednisolone the morning of surgery with anti-thymocyte globulin, and for maintenance, tacrolimus 3 mg orally BID with a target trough of 5-10 ng/mL, azathioprine 100 mg orally, and prednisone only 5 mg po daily, with tacrolimus eventually discontinued. By 168 days post-op the Turner’s recipient was menstruating normally and her FSH had reduced to 9.13, with no signs of rejection. Her menstruation and ovulation continued monthly. Her AMH began to rise at 168 days from 0.05 to 0.35 by 223 days, typical for a successful ovary cortical graft. By 530 days the allograft is still functioning normally and she continues her monthly menstruation and normal ovulation. By six months her uterus grew from infertile to that of a normal adult. IVM from the transplanted ovary tissue resulted in a total of 17 good quality metaphase II oocytes, which were vitrified. The donor FSH was 6.8, unchanged from pre-op, she continued menstruating normally, and became spontaneously pregnant with her third child (despite having an IUD in place) by six months post op. We report the first successful ovarian tissue transplant to a Turner’s syndrome female using a safe immunosuppression protocol. The fact that ABO incompatibility did not cause rejection indicates that an ovary tissue graft can survive on diffusion alone even if there is no neovascularization." @default.
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• W4387396238 date "2023-10-01" @default.
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• W4387396238 title "FIRST OVARY ALLOTRANSPLANT TO A TURNER’S SYNDROME PATIENT: IMMUNOSUPPRESSION AND IVM" @default.
• W4387396238 doi "https://doi.org/10.1016/j.fertnstert.2023.08.736" @default.
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