A remarkable 20 years after freezing her ovary, an Israeli woman defrosted part of it, reversed her menopause, got pregnant without IVF, and has now given birth to a healthy baby girl.
She has named her new daughter Eshkar, a word from the Bible that means gift.
The 46-year-old woman, who asked to be identified only by her first name, Tzvia, froze her ovary when she had cancer in her mid-20s.
At that time, the idea of transplanting a healthy ovary back into a woman after she recovered from cancer was just theoretical. In 2016, a woman in Dubai became the first to give birth to a baby after having her ovary retransplanted, and since then there have been hundreds more pregnancies worldwide — though none came after an ovary was frozen for two whole decades.
“She conceived spontaneously at age 45, and she now has a baby girl thanks to pieces of her ovary that were in liquid nitrogen for two decades,” her gynecologist, Prof. Ariel Revel, told The Times of Israel.
“I visited her home after the birth and cried tears of joy, thinking about the fact that hopes in a lab all those years ago actually resulted in a baby,” Revel added.
“Not only is this a world record, but it also raises the possibility that in the future woman could routinely conceive much older by freezing ovaries in their 20s. What is more, it suggests that this could provide a way to actually prevent menopause.”
Revel, a leading specialist in gynecology and obstetrics, met Tzvia soon after her cancer diagnosis. “She was told that she needed aggressive chemotherapy which could harm her ovaries,” he recalled.
“She came from a religious [Jewish] background and having children was important for her. I had just received permission [from ethics boards] to remove and freeze an ovary, and we removed her right ovary before her bone marrow transplant.”
Ten years later, Tzvia asked to unfreeze part of the ovary and receive it as a transplant. She quickly conceived using IVF — as is the norm after ovarian transplants — and the baby from that pregnancy is now nine years old.
“After the birth, for a few years she didn’t come to see me,” Revel said. “Then, she and her husband wanted another baby. The pieces of ovary we transplanted were no longer working — she had passed menopause. But I had other slivers of her ovary in liquid nitrogen, so I removed some, and performed surgery.”
The transplant, which he performed at Jerusalem’s Hadassah Medical Center, was covered by Israel’s basket of publicly funded health treatments.
Revel said that it “reversed her menopause,” explaining: “When production of estrogen ceases, symptoms of menopause set in, but if healthy ovaries are returned, it restarts the woman’s period, makes her fertile again and triggers the production of estrogen.” The doctor predicted that Tzvia now won’t enter menopause for several years — for as long as the newly transplanted ovary pieces remain active.
After that transplant, Tzvia once again started IVF. Two cycles yielded no pregnancy, but as she was readying for a third cycle, funding rules stopped her in her tracks.
While Israel’s public health system is generous in funding multiple IVF cycles, it stops at age 45 — and Tzvia had just turned 45. “We started trying to convince authorities to fund more cycles for her, arguing in a letter that her ovary is actually younger than 45 so she should be allowed,” Revel recalled. “Then, when we were waiting for a response, she called me and said she missed her period. I told her to run and get a pregnancy test — and she was pregnant.”
“She cried tears of happiness — and so did I.”
Revel believes that the discovery that ovaries can be transplanted after such long stints frozen could prompt a rethink on guidelines. Today, ovary freezing and transplant is generally limited to women facing serious illness. But he believes it could be seen as a legitimate way for healthy women to extend their childbearing years.
Revel added that fertility aside, providing older women with their own “young” ovaries that were frozen could prevent or significantly delay menopause.
“This could actually prevent menopause, which is a major medical issue in women’s health, as it prompts all sorts of medical challenges,” he said. “This is theoretical as today you can’t remove and preserve an ovary from people unless there is a medical reason. But it could become very real.”