A series called ‘Gonads’ by RadioLab is looking into human reproduction. Their second episode, which is the source used for this article, can be found here. It explores the story of Greg and Annie, who amazed doctors when they became the first couple in the US to have a child after ovarian freezing and transplant.
Annie’s First Diagnosis
Greg and Annie first met and began dating over twenty years ago. Around one year into their relationship, Annie was diagnosed with cancer. She first went to the doctors after she woke up one morning and felt “a 100-pound weight on my chest, like I couldn’t catch my breath.”
Her doctors diagnosed her with Hodgkin lymphoma. They had found a massive tumour that she says was around the size of a grapefruit down her breastbone, over her heart and lungs. The survival rate for this type of cancer has improved significantly over the last few decades, and Annie’s doctor told her that it is now more treatable than it once was. Annie, worried about what her diagnosis meant for their relationship, told Greg that he didn’t need to stay. Instead, he decided to propose.
Nine Months Later
After nine months of treatment, the cancer still wasn’t completely gone, and, Annie says, the doctor looked scared. She wanted to go to see a different doctor, but her insurance wouldn’t allow it. However, Greg’s would, and they decided to get married sooner than they had originally planned. They had a small wedding with their families, and, six days later were in New York, seeing a new doctor who put Annie through another month of testing. This time, the diagnosis was different. Annie was told that she had non-Hodgkin lymphoma, a very aggressive form of cancer. Annie says her survival chances were estimated to be around 30%.
The doctor set out a treatment plan – aggressive chemotherapy and a stem cell transplant. Annie asked about her fertility; she and Greg were married now, and they had always planned on having children together. Having a family was important to both of them. “Forget fertility, you’re fighting for your life,” Annie says the doctor responded. But Annie was insistent; she was going to beat this, and afterwards, she wanted to have a family.
The problem was that Annie needed to begin treatment within a week, and standard fertility treatments at that time took much longer. Across the street, a researcher called Dr Oktay was experimenting with freezing the whole ovary. Annie was one of the first patients to undergo his extremely experimental procedure, and, one week later, her chemotherapy treatment began.
Annie says that the chemotherapy regime was “constant”; at the weekend, she had chemotherapy “non-stop”. She had to undergo a stem cell transplant to help to re-grow her immune system. But, eventually, she was told she was clear.
Revisiting Dr Oktay
After two years without a relapse, she went back to Dr Oktay to talk about what could be done to help her have children. At this point, no one had ever had a child after having an ovary frozen and replanted. Annie’s ovary was re-inserted just under her belly button, and, two weeks later, Annie began developing bumps under her skin from eggs.
Within five years after re-implantation, Annie became pregnant four times and gave birth to three children. Doctors didn’t understand how her pregnancies had happened. One theory was that egg cells had migrated from the implanted ovary under her belly button through the bloodstream to her uterus and matured; another possibility is that re-implanting the ovary ‘woke up’ the second one that had stopped functioning after aggressive cancer treatment.
Annie’s first child, Sienna, was born healthy on the 25th September 2005. Sienna is the first baby born in the US from an ovarian transplant.
Sienna now has two siblings, and since her birth, the same procedure has been used to help many more people who hope to conceive one day.
To hear more about Annie’s story in her own words, click here to listen to the original RadioLab program presented by Molly Webster. To read more about how the pregnancies could have happened, click here to Dr Oktay’s article in the journal Human Reproduction, or here to read his paper in the American Society for Reproductive Medicine.