Fertility preservation with successful pregnancy outcome in a patient with transplanted heart and non-Hodgkin's lymphoma - a case report

• Autor(a) principal: Pais, Ana Sofia
• Data de Publicação: 2019
• Outros Autores: Guerra, Nuno, Couto, Daniela, Sousa, Ana Paula, Almeida-Santos, Teresa
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10316/106837; https://doi.org/10.1186/s12884-019-2587-x
• topic: Pregnancy; Oocyte cryopreservation; Pelvic irradiation; Heart transplant; Adult; Female; Fertility Preservation; Fertilization; Humans; Live Birth; Lymphoma, Non-Hodgkin; Postoperative Period; Pregnancy; Pregnancy Complications, Neoplastic; Cryopreservation; Heart Transplantation

Background: Fertility preservation must be discussed with reproductive age women before cancer treatment. Heart transplantation raises complex issues in pregnancy. Pregnancy in a heart transplant woman after pelvic irradiation involves close multidisciplinary follow-up to avoid complications in the mother and the foetus. We report the first live birth in a heart transplant woman after pelvic irradiation, chemotherapy and fertility preservation. Case presentation: A 36-year-old heart transplant woman with pelvic non-Hodgkin lymphoma spared her fertility, with cryopreservation of oocytes and embryos, before chemotherapy and pelvic irradiation. After multidisciplinary discussion and pre-conception evaluation, pregnancy was achieved. A close follow-up by a multidisciplinary team allowed a normal pregnancy without maternal or foetal complications and the delivery of a healthy infant. Conclusions: Achieving pregnancy in heart transplant women with iatrogenic ovarian failure after oncologic treatment including pelvic irradiation is possible and can be successful. Careful and close surveillance by a multidisciplinary team is mandatory due to increased risk of maternal and foetal complications.