STEPHEN ADAMS
Women will be able to give birth in old age following an ovary transplant breakthrough that means they can postpone menopause until well after their 50s.
The technique to remove parts of an ovary, store them for decades and then transplant them, could effectively put menopause "on ice", doctors have said. Only physical ability to carry a baby would prevent women from becoming mothers, meaning they would no longer have to think about the "biological clock".
A conference in Istanbul was told that 28 babies had been born to infertile women who had ovary tissue transplants, and that most of the children were conceived naturally without the need for IVF or drugs.
Dr Sherman Silber, an American surgeon who has been involved in transplants for 11 women at a hospital in St Louis, Missouri, said: "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.
"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."
Scientists said the treatment could also have health benefits, by avoiding the increased risk of osteoporosis and heart disease linked to menopause. They admitted, however, it may raise the risk of breast and womb cancer.
Dr Silber said that women who had transplants eight years ago were still fertile, showing that the science behind the technique was "robust".
A transplant from one 38 year-old to her identical twin has lasted seven years so far without failing. In that time, the recipient has had two healthy baby boys and a baby girl, all without IVF, conceiving the last aged 45.
At first it was thought the transplants would only last months, or a few years at most, giving the women just a brief chance of conceiving. But Dr Silber said early hopes had been surpassed.
In Belgium, a woman has given birth after her ovarian tissue was frozen for a decade, and in Italy a woman has recently had a healthy baby girl after her tissue was frozen for seven years.
Dr Silber said: "It's really fantastic. We didn't expect a little piece of ovarian tissue to last this long."
He said that ovarian slices could now be frozen for decades, thawed out for replanting when needed, and be just as effective as "fresh" grafts between twins. The tissue would not have aged - effectively halting the woman's body clock. One of his patients has had a baby using ovary tissue that was frozen for 12 years.
Dr Silber and his European colleagues presented their findings at this week's European Society for Human Reproduction and Embryology.
They wrote: "All modern women are concerned about what is commonly referred to as their 'biological clock' as they worry about the chances of conceiving by the time they have established their career and/or their marriage and their financial stability.
"Most of our cured cancer patients, who have young ovarian tissue frozen, feel almost grateful they had cancer, because otherwise they would share this same fear all modern, liberated women have about their 'biological clock'." The first operation, conducted in Belgium in 2003, led to a successful birth a year later. Strips of ovarian tissue were removed from the woman before chemotherapy treatment for Hodgkin's lymphoma and replaced after the all clear.
In 2008, London's The Daily Telegraph disclosed that Susanne Butscher, who received a whole ovary transplant in a world first from her twin, had given birth. Dr Silber carried out the operation in 2007 after Mrs Butscher, then 39, had an early menopause. The majority of the women have undergone a transplant after having had cancer, but doctors said it was time to extend it to others.
Dr Gianluca Gennarelli, a gynaecologist involved in the Italian operation, said in time it should be made available to women with other conditions, including those likely to suffer early menopause. "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."
Tim Hillard, a gynaecologist and trustee of the British Menopause Society, said: "This is an exciting development as a fertility treatment, however we would need much more data before claims could be made about the menopause.
"You would have to balance it very carefully, the higher risks of breast and womb cancer that go with having oestrogen circulating for longer against the increased risk of heart disease, osteoporosis and maybe dementia that go with the menopause."
He added that theoretically it could be used as an alternative to hormone replacement therapy.
source: http://www.theage.com.au
