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THE GUARDIAN
CONSCIENCE, NURTURED BY TRUTH
LAGOS, NIGERIA.     Friday, July 02 2004
 

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020704 today:
Woman pregnant after frozen ovary graf

DOES any woman wish to bypass menopause, freeze her ovaries in the 20s and begin to have children in the 50s and 60s

  • Or, is she a cancer patient downcast at the prospect of being unable to have children following chemotherapy
  • Some Belgian scientists have made possible the hitherto considered impossible medical problem: They have made pregnant, a woman who seven years ago had an ovary tissue transplant.

    The patient, whose identity is yet to be disclosed, was diagnosed with advanced Hodgkin's lymphoma in 1997. Her ovarian tissue was removed before chemotherapy, then transplanted back after she was declared cancer free.

    The "miracle baby" girl is due in October.

    The procedure gives hope to thousands of cancer patients whose treatment can make them infertile.

    The research was announced yesterday at the annual conference of the European Society of Human Reproduction and Embryology (ESHRE) in Germany.

    The pregnancy, the first of its kind in the world, offers hope to thousands of young women with cancer who would otherwise be unable to have children.

    The 32-year-old woman was given the ovary graft at the Catholic University of Louvain, Belgium.

    The Daily Telegraph of London on Wednesday reported a university spokesman as saying: "The research team has managed to achieve what no other team in the world has been able to do - give a young woman who underwent cryo-preservation of ovarian tissue prior to cancer treatment the gift of pregnancy."

    The woman was suffering from Hodgkin's lymphoma and needed radiotherapy and chemotherapy in 1997. Because the treatment would have made her infertile, doctors agreed to remove one of her ovaries and freeze it in liquid nitrogen at minus 196 C.

    In 2003, when she was given the all-clear, strips of the ovarian tissue were defrosted and implanted close to her remaining, but now useless, ovary. Within four months the graft was working.

    The tissue began producing hormones and, after six years of enforced early menopause, her menstrual cycle began again. In January, the woman found that she was pregnant. The foetus is now 25 weeks old and healthy.

    Details of the pregnancy were discussed yesterday at the European Society for Human Reproduction and Embryology conference in Berlin. The team, led by Prof Jacques Donnez, was reluctant to discuss its work before it appeared in a peer-reviewed medical journal.

    But Prof. Donnez told a Brussels radio station this year that the patient "felt like a woman again in her relationship with her husband. She did not have to take hormones any more. She was cured of her cancer and she felt alive again.

    "She lives a life she could not hope to live in 1997. She knew that she was going to be post-menopausal and now she is expecting a child."

    The breakthrough was welcomed by cancer charities and organisations representing infertile couples. Infertility Network UK said: "This seems tremendously exciting. It will give new hopes to women who have had treatment for cancer and would otherwise be facing a lifetime of childlessness."

    Simon Davies, of the Teenage Cancer Trust, said: "It is going to be worthwhile for cancer patients, particularly younger ones, and will give them more choices in the future."

    The first ovarian transplant was carried out in the late 1990s by Dr Kutluk Oktay, of Cornell University, New York.

    That failed after a few months. Since then, Dr Oktay has implanted ovarian tissue into several cancer patients and produced healthy embryos. Unlike the Belgian team, he implants the ovarian tissue under the skin and then extracts eggs to create test tube babies.

    "If they prove this did not come from a natural recovery of ovarian function, it is a landmark," Dr Oktay said. "Many cancer patients see this as a bridge between them and their future. It helps them cope with cancer and be much more positive about what they are going through."

    Although the technique was developed to help women with cancer, Dr Oktay said it could also be used to reverse the menopause. "If I found that this procedure gives a 30 per cent pregnancy rate, which is similar to IVF, why not

  • "

    The anti-abortion organisation, Life said the technique should not be used as a lifestyle choice for otherwise healthy women.

    Prof. Jack Scarisbrick, a spokesman, said: "There are good reasons for a woman's procreative career to end - for the sake of her children and herself. This is a very important development, but trying to defeat nature is not the right use for it."

    Dr David Purdie, an Edinburgh specialist in hormone replacement therapy and the menopause, said it would be difficult to determine whether the pregnancy was a result of the ovarian graft. "There is a chance that the woman's other ovary recovered naturally and produced the egg," he said.

    Doctors said the surgical procedure was very complicated. Dr Paola Albertazzi, a consultant gynaecologist at Hull University's centre for metabolic bone disease, said: "Removing an ovary, freezing it and re-inserting it is a very difficult thing to do. It is an organ and so it needs to be vascularised and the blood supply needs to be reworked. Re-inserting a uterus is hard enough, but it is even worse with an ovary because it is a gland and so very delicate. I don't want to raise women's hopes."

    Doctors said the surgery should be carried out only in extreme cases; it was not an option for women wanting to delay having children for career reasons.

    "The organ of any healthy woman should not be removed unless it poses a significant threat to her health," Dr Purdie said. "The best way for healthy women to switch off their ovaries is not to put them in the freezer but to use the contraceptive pill."

    He said the procedure would be a useful advance for cancer sufferers if further tests were successful. Ovarian surgery is not an option for all early menopause sufferers, as the ovary has to be removed before the menopause begins.

    Charlotte Woodhouse, 23, from Biggin Hill, Kent, underwent the menopause at 14. She said: "It is not an option for me because my ovaries have shrivelled up. But it is great for people at an early stage."

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