27-year-old Neha* had got her uterus, Fallopian tubes and ovary removed in 2014. With this, she had lost all hopes of becoming a mother. Neha, who had grade 2 cancer in her uterine wall, had to undergo surgery. But luckily, her surgeon, Dr Chithrathara K, decided to save her right ovary and leave it right below the skin, in her anterior abdominal wall.
Five years later, Neha is now the mother of a baby girl. The GG Fertility Centre in Chennai, which helped her achieve motherhood, believe this is first of its kind surgical procedure in India.
Holding the four-day-old baby, who weighs a little more than 2.5 kilos, Fertility Specialist Dr Priya Selvaraj, who led the operation, said that Neha's story gives hope to scores of young cancer survivors, who wish to become mothers in future.
Saving ovary during cancer treatment
Dr Chithrathara, who is the head of Oncology at Lakeshore Hospital in Kerala, said that she decided to save Neha's right ovary as it looked healthy. Usually, if there is a risk of cancer in the organs, all of it is removed. But in Neha's case, the doctor decided to retain the healthy ovary to prevent early menopause as she was just 26 years old then.
Explaining her reasons for the unique choice of location to save the ovary and the blood vessel, Dr Chithrathara said that storing the organ right below the skin made it easily accessible. It could be removed with a simple outpatient procedure by doctors, in case the ovary turned malignant later on.
Transposition of ovaries is usually done in young cancer patients to ensure the organ is not affected during the treatment. “Exposing the ovaries to radiation blasts could acutely affect their functioning. This is why, the ovaries are removed to other, safer locations, usually inside the abdomen or right above the pelvic brim,” says Dr Priya.
How Neha became a mother
Dr Priya says that usually, the eggs are retrieved for IVF only through the vagina. In Neha's case, it was the first time that the eggs were retrieved the skin (transcutaneous). It took Dr Priya and her team three attempts to successfully retrieve the healthy eggs.
"Once the eggs are removed, it is fused with the sperm and then transferred to the surrogate mother's womb. Usually, getting healthy eggs in such cases is rare," she said.
This is the first such case of surrogate pregnancy in India, where eggs were harvested through the skin, says Dr. Priya. Globally, a few published cases focusing on this prodcudre exist.