November 10, 2008

Sterile Woman Set To Give Birth

A barren woman is about to deliver the world's first baby conceived after a complete ovary transplant.

The 38-year-old was labeled infertile after her ovaries stopped working at the age of 15, which caused her to have an early menopause. After getting an ovary transplant from her twin sister, the woman will give birth shortly.

The innovative surgery gives hope to more than 100,000 women who struggle through a premature menopause, but also to women receiving chemotherapy or radiotherapy in cancer treatments.

The successful operation also allows for the option of women to freeze ovarian tissue to put off motherhood for various reasons, like postponing marriage or not wanting interruption in their careers.

Different from IVF, the most common infertility process, an ovary transplant not only lets a woman conceive "naturally," but reestablishes hormone levels in women who have had a premature menopause. The hormones created in the ovaries, estrogen, progesterone and testosterone; influence the female body in several ways, like starting monthly periods and guarding bones from osteoporosis.

Following the ovary transplant, the sterile woman experienced periods for the very first time in 22 years. After the initial joy of finding herself pregnant, the osteoporosis she had suffered with prior to the surgery looked like it was improving because of replenished hormone levels.

The woman's twin, who has two children of her own, was ready to give one of her ovaries to allow her sister the choice and blessing of becoming a mother.

The baby is, genetically, the twin sister's biological child.

The transplant was performed last year by Dr Sherman Silber, the microsurgery pioneer of the Infertility Center of St Louis in Missouri.

Silber took the ovary from the donor twin by using method called keyhole surgery. He put the ovary into the receiving twin and connected miniscule blood vessels to allow for blood to flow to the donated organ.

Three months after receiving the transplant, the woman started to ovulate regularly and her hormone levels were equivalent to those of her healthy twin. The woman found out she was expecting a year after the transplant.

Silber, who will talk about the pregnancy at a meeting of the American Society for Reproductive Medicine on Tuesday, referred to the reestablishment of the arteries and veins in the course of the transplant as "extremely delicate".

"Reconnecting these blood vessels deep inside the pelvis can be a tactical challenge. The ovarian artery is less than a third of a millimeter in diameter, in fact so small [that] many gynecologists have never seen it," he said.

The transplant donated from an identical twin made it pretty certain that the organ would be accepted.

Gynecologists have also performed transplants of strips of ovarian tissue, which have allowed for three births. This is the first successful pregnancy as a result of an entire ovary transplant, even though a series of the transplants has been performed by Silber in the past. Silber thinks that an entire ovary may last for up to ten years.


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