Scientists have successfully transplanted ovarian tissue back into a 30 year old woman who had the tissue removed and cryopreserved a year earlier.
The technique, pioneered by Professor Roger Gosden at the University of Leeds and carried out at New York Methodist Hospital by Dr Kutluk Oktay, offers hope of some degree of fertility to women who have ovarian tissue removed and banked prior to chemotherapy.
But fertility specialists urged caution after widespread popular speculation that the success of the operation could mean the end of the menopause and herald the arrival of fertility at any age, as well as preventing ageing and replacing hormone replacement therapy.
The patient who underwent the procedure, 30 year old American Margaret Lloyd-Hart, had lost one ovary when she was a teenager because of cysts, and had the other removed last year because of an undisclosed hormonal problem. Before the second bout of surgery, she had decided to have tissue preserved at a unit that provides cryopre-servation at the University of Arizona.
After the operation she began to experience menopausal symptoms and sought out Professor Gosden, who has performed ovarian grafts on sheep. His work was focused on the possibilities of banking ovarian tissue for women about to undergo chemotherapy to protect it from sterilisation, but an obstacle to working on humans was the risk of transferring cancer cells with the tissue. With Ms Lloyd-Hart there was no such risk, and the operation went ahead.
“This is proof of the principle that ovary grafts could be used to rescue fertility. There is no reason why ovaries could not be stored for decades,” said Professor Gosden.
In the aftermath of the success, there has been extensive speculation about the long term implications, but fertility specialists are more cautious.
“Biologically, it is a very important development because it shows that ovarian function can be restored to some extent. But when it comes to clinical practice, people have to understand that its use is very limited and the ideas of longevity are grossly exaggerated,” said Professor Michael Hull, professor of reproductive medicine at the University of Bristol.
“The only real place for this kind of technique is to preserve the eggs in a woman whose eggs are likely to be destroyed in cancer therapy, and with the specific purpose of achieving temporary fertility at some time in the future,” he continued. “It is particularly important for the increasing number of girls and young women who are successfully treated for cancer and who could lead a normal healthy life but who are caught by the double whammy of infertility.”
He added, “There is no way anyone can say that the menopause can be put off and that women will be feminine for ever. That is a non-starter; it is ridiculous.”
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PHIL NOBLE/PA NEWS
Professor Roger Gosden of Leeds University, who has pioneered the transplantation of ovarian tissue