July 5, 2012
Ovary Transplants Delay Menopause, Give Women More Time To Conceive
Lawrence LeBlond for redOrbit.com - Your Universe Online
Successful ovary transplants could lead to women remaining fertile indefinitely and also postponing menopause until they are well in their 50s, according to doctors speaking at a conference in Istanbul.
The breakthrough uses a technique to remove pieces of ovary, store it away for decades, then transplant it back later in life, perhaps effectively holding off menopause as well. The doctors said that only physical inability to carry a baby would prevent women from becoming mothers late in life.
The controversial method would give career-minded women peace of mind with so-called fertility insurance, allowing them to put off having children until they are financially secure.
Doctors told the conference that 28 babies had been born to infertile women who had the ovary tissue transplants, and that most of the children were conceived naturally without need for IVF or drugs.
They added that by delaying the menopause, women could also avoid the risk of osteoporosis and heart disease that usually coincide with menopause. However, risk of breast and womb cancer would be increased, they cautioned.
“A woman born today has a 50 per cent chance of living to 100. That means they are going to be spending half of their lives post-menopause,” American surgeon Dr. Sherman Silber, told the conference. “But you could have grafts removed as a young woman and then have the first replaced as you approach menopausal age. You could then put a slice back every decade.”
“Some women might want to go through the menopause, but others might not,” said Silber, who has been involved in transplants for 11 women at St Luke´s Hospital in St Louis, Missouri, US.
He noted that transplants he and his staff carried out more than eight years ago are still working, showing that the technique is ℠robust´ and it should no longer be considered experimental. One transplant from a 38-year-old to her identical twin, has lasted seven years so far without failing. In that time the recipient has had three healthy babies, all without IVF, conceiving the last at age 45.
Doctors had initially believed that ovary transplants would only last months, or at most a few years, offering only a brief shot at conceiving. But Silber and his colleagues said those hopes have been surpassed.
“It's really fantastic, we didn't expect a little piece of ovarian tissue to last this long,” he elated. Being frozen for decades, then thawed out for replantation when needed, and to be just as effective as fresh grafts, its amazing. And in the meantime, the tissue would not have aged -- effectively putting the woman´s biological clock on ice, he added.
His findings were presented this week at the European Society for Human Reproduction and Embryology (ESHRE) in Istanbul.
The Telegraph reported in 2008 that one patient of Dr. Silber, Susanne Butscher, who had received a whole ovary transplant from her twin sister, had given birth to a healthy baby girl. Butscher, then 39, had already gone through menopause, but the doctors carried out the operation anyway and 13 months later it was confirmed that she had conceived naturally.
Silber said the majority of the women who underwent the procedure had cancer, but said its now time to extend it to others.
In time, this procedure should be made available to women with other conditions, said Dr. Gianluca Gennarelli, a Turin-based gynecologist, adding it should be included for women who likely suffer early menopause due to family history.
“In the 21st century many women don't want to have children until they are in their 30s, rather than at 18. But if your mother went through menopause before 40 that could be very difficult,” he noted.
“This is an exciting development as a fertility treatment, however we would need much more data before claims could be made about the menopause,” Tim Hillard, a gynecologist and trustee of the British Menopause Society, told Stephen Adams at the Daily Telegraph. “You would have to balance it very carefully, the higher risks of breast and womb cancer that go with having estrogen circulating for longer against the increased risk of heart disease, osteoporosis and maybe dementia that go with the menopause.”
He noted that the method could also have significant implications as an alternative to hormone replacement therapy, but said that could be more than a decade away.