Courtesy of Yale New Haven Hospital

A new medical procedure at Yale New Haven Hospital has provided a second chance at fertility for a Connecticut woman.

Oktay successfully performed New England’s first ovarian transplant at Yale New Haven Hospital — or YNHH — this past August. The patient, who is now in her 30s, previously underwent a bone marrow transplant at age 20 that induced premature menopause. However, transplanted ovarian tissue offered her a chance to regain fertility. 

The patient, currently undergoing follow-up evaluations, has shown initial signs of ovarian function. Full functionality has yet to be confirmed as it may take three to six months, but early indications are promising.

“This procedure marked a significant milestone in reproductive medicine, showcasing the boundless possibilities of science and hope,” Oktay said.

The transplantation was designed to restore natural ovarian function, which is vital for reproduction. The procedure required extensive preparations, including mock surgeries to ensure seamless execution on the day of the operation.

During the procedure, doctors transplant ovarian tissue — previously removed and frozen — back into a woman’s ovary or a nearby place in the pelvis. In the August procedure, doctors used ovarian tissue cryopreserved by Oktay in 2006. 

The tissue is thawed and placed on a support structure called the scaffold. This scaffold provides structure to promote blood vessel growth, so the tissue can integrate and function effectively within a patient’s body.

This tissue contains follicles, or immature eggs, which can restore natural hormone production and fertility.

Oktay pioneered ovarian tissue cryopreservation. When he started freezing it, he was unsure if the process would be successful. 

The technique has improved over the years, making it a more established option in reproductive medicine. This particular transplant was also notable for its use of advanced robotic technology, which allowed for precise stitching of the graft to the ovary.

Dr. Emre Seli, a professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine and the medical director of Yale Fertility Center, said that the number of eggs and follicles present in the ovarian tissue prior to its cryopreservation, the technique used to freeze the tissue and the technical ability of surgeons and lab personnel all play crucial roles in determining the success of the transplantation. 

“This technique allows for natural ovarian function restoration, which is significant, especially for younger patients or those unable to undergo traditional methods,” Dr. Hugh Taylor, chair of obstetrics, gynecology, and reproductive sciences at Yale, said. 

The implications of ovarian tissue transplantation extend beyond fertility restoration. 

In addition to addressing fertility, the transplant can restore natural hormone production to address hormonal imbalances. A return to a normal hormone balance could provide relief from menopausal symptoms, such as irregular periods, hot flashes and night sweats.

Seli highlighted the broader impact of ovarian transplants, particularly for cancer survivors. 

“The increasing utilization of this procedure will give hope of parenthood to a large number of young cancer patients in the near future,” he noted. 

As ovarian tissue cryopreservation continues to evolve, efforts are focused on improving techniques to maximize its effectiveness.

Despite its promise, the wider adoption of this technique is challenging. Oktay noted that only a handful of surgeons worldwide can perform it successfully. Additionally, Taylor underscored that financial limitations often prevent patients from pursuing this option.

According to Taylor, the procedure’s classification as elective fertility preservation means that it is rarely covered by insurance, leaving many patients unable to afford it. The combination of high surgical costs and ongoing follow-up care creates a significant financial barrier.

Still, Yale New Haven Hospital remains committed to becoming a global hub for advanced fertility preservation techniques, with Oktay at the forefront of these innovations. He believes that the procedure “represents an opportunity for many women to regain what was lost.”

Ovarian cancer is the second most common gynecologic cancer in the country.