The pioneering surgeon behind the world’s first ovary transplant says women could use the same technique to delay childbearing and the menopause.
Dr Sherman Silber predicted that ovarian transplants for social reasons were a realistic option for preserving fertility.
The US microsurgeon transplanted a whole ovary from one identical twin to another in 2007, who had been made infertile when her ovaries failed at the age of 15. The 38-year-old woman gave birth following year.
The drugs used may destroy the ovaries, so slices are taken in advance and stored in the deep freeze. They can be re-implanted when the woman is ready to start a family and so far 22 women have given birth after having their own ovarian tissue restored.
The latest success was achieved in Italy seven years after a 21-year-old woman had ovarian tissue frozen prior to cancer treatment.
Details were released at the annual meeting of the European Society of Human Reproduction and Embryology in Istanbul, Turkey.
Dr Silber, who practises at the Infertility Center of St Louis, Missouri, presented his own data on three women who had frozen and thawed ovary grafts and nine women who had fresh ovary grafts, usually donated by relatives.
One woman had ovarian tissue implanted to treat premature menopause caused by cancer drugs, while another had a graft to treat a naturally premature menopause. Eight babies have been born in total to the women, with one graft lasting seven years so far.
Dr Silber said: ‘Transplanted cryopreserved or fresh ovarian tissue can robustly restore menstrual cycles and fertility and may even in the future be used to postpone the normal time of menopause or to alleviate its symptoms.’
It was a remedy for severe bone loss caused by premature menopause because the new ovary would supply the body’s missing hormones, he said.
At present women going through a premature menopause in their 20s or 30s are offered Hormone Replacement Therapy to alleviate the symptoms. Dr Silber has previously claimed ovary transplants could be a solution to growing fertility problems caused by delayed childbearing among career women. He said: ‘It is the modern way, It is not just England and the US – in every society women are putting off childbearing.’
In 2008 he predicted that women who had an ovary frozen in their 20s could look forward to the best of all worlds. They would have their own young eggs in storage that were superior to donor eggs, he said.
‘It’s very realistic. Women can always have egg donation but this is so much nicer and more convenient if it’s safe. ‘A young ovary can be transplanted back at any time and it will extend fertility and delay the menopause. You could even wait until you were 47.
‘I don’t see any problem with it at all, I don’t see a dilemma’ he added. However, British experts said ovarian transplant techniques were originally developed to help women facing infertility through cancer treatment and this was likely to remain the case for the foreseeable future.
Professor Nick Macklon, medical director of the Complete Fertility Centre, Southampton, and chair in obstetrics and gynaecology at Southampton University, said ovarian tissue freezing for cancer patients was beginning to become established in the UK. He is starting the third centre and is ‘optimistic’ about getting NHS funding for the service.
He said ‘The technique is novel but not experimental.
‘It’s very important for girls who have no other option and who face losing their fertility because of cancer treatment at the age of eight or nine.’ But, he added, using the technique for social reasons raised ethical issues that would need to be debated by society as well as doctors.
Via The Daily Mail