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PREGNANCY AND BIRTH FOLLOWING SUCCESSFUL OVARY TISSUE TRANSPLANT OFFERS NEW HOPE TO INFERTILE WOMEN

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Stephanie Yerber became infertile after going through premature menopause at age 14. Her identical twin sister, Melanie had no such problems and eventually married and had three children. For 10 years, Stephanie had no periods and her ovaries did not produce any eggs. Melanieís attempt to donate her eggs to Stephanie failed as did repeated attempts at IVF (in-vitro fertilization). At 24, hopes of having her own children faded for Stephanie.

Then, in a five-hour operation performed at St. Lukeís Hospital in St. Louis in April 2004, Dr. Sherman Silber and his surgical team removed one of Melanieís healthy ovaries and transplanted one-third of the outer tissue from it on each of Stephanieís shrunken ovaries. The remaining third of the tissue was frozen in the event it is needed later. The fact that the women are identical twins made rejection unlikely and increased the chances that the transplant would be successful.

Three months after the surgery, Stephanieís menstrual cycle returned and soon became regular. After two cycles, Stephanie became pregnant and, after a full 9-month pregnancy, gave birth to a healthy baby girl late Monday. The research and commentary on this case will be forthcoming in next monthís issue of the New England Journal of Medicine. The journal made the study available online on Tuesday because of the birth and the technical advance the procedure represents.

The researchers say it is almost certain the egg involved came from Melanieís grafted tissue since a biopsy had shown Stephanieís ovaries were not producing eggs and she had not menstruated for over 10 years. The procedure offers hope for women who have become infertile as a result of premature menopause (like Stephanie) and the high percentage of women who become infertile following high-dosage chemotherapy for cancer.

Recently, there have been similar advances by researchers in other countries which offer their own possibilities for fertility breakthroughs. These include the following:

2004 ñ A Belgian team removed ovarian tissue from a cancer patient which was then frozen and transplanted back into her abdominal cavity. The woman involved subsequently delivered a baby.

In still unpublished research, an Israeli team announced (in May) at an international fertility meeting that they had performed a procedure similar to the one in Belgium on a 31-year-old woman who had undergone a bone marrow transplant and chemotherapy. An IVF was done with the womanís egg and the embryo was then implanted. She is due to give birth shortly.

Several hospitals and medical facilities are harvesting and banking ovarian tissue from women diagnosed with cancer in the hope that a transplantation technique will be perfected in time for them to have a child of their own.

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