Ovary Transplant
In recent years, surgeons all over the world have been trying to develop a successful procedure for transplanting ovarian tissue or indeed whole ovaries into infertile women, to help such women get pregnant. The good news is that surgeons have indeed succeeded in helping previously infertile women give birth to healthy babies, although the procedure remains experimental and further development needs to be carried out.
Tissue Transplant
In 2004, the first baby born to a woman who had received an ovarian tissue transplant entered the world. The mother, who was from Belgium, had become infertile after receiving treatment for cancer. Before she began taking her cancer drugs, she had some tissue surgically removed from one of her ovaries and frozen. After her treatment was completed and she was given the all-clear, surgeons inserted the tissue back into her body, just below her remaining complete ovary (which had been left inside her). After a few months she began menstruating again and, eventually, she conceived naturally and gave birth to a healthy baby.
Some experts claimed at the time that the woman's second ovary had simply "come back to life" when the cancer treatment ended. However, in 2005, an Israeli woman who had experienced complete ovarian failure before she received a transplant of her own ovarian tissue became pregnant. She had frozen her tissue after one round of chemotherapy treatment, before she completely lost her fertility. In this case, strips of the live tissue were attached to one of her "lifeless" ovaries and more tissue was injected into the other ovary. The woman began menstruating nine months after the transplant and conceived via IVF. She gave birth to a healthy baby. Because doctors were sure the Israeli woman's ovaries had stopped working altogether before the transplant, they said it was certain that the transplant had kick started her ovarian function.
Ovarian tissue transplants from one genetically identical twin sister to another, and even between non-genetically identical sisters, have successfully induced menstruation in previously infertile patients. However, not every transplant procedure has ended in a successful pregnancy.
Whole Ovary Transplant
A transplant of one whole ovary from one twin sister to another was carried out on nine sets of twins before any previously infertile woman gave birth. The first baby to be born, thanks to the revolutionary procedure, entered the world in November 2008. The infertile woman in question had experienced early menopause. Dr. Sherman Silber of the Infertility Centre of St. Louis, Missouri, in the United States, took a healthy ovary from the woman's twin sister and used microsurgical techniques to attach it to the infertile twin's blood supply and position the new ovary correctly alongside her fallopian tubes. She began menstruating a few months later, conceived naturally, and is now a mother.
Who Is A Candidate?
Fertility specialists are very excited about these new opportunities for infertile couples. They do say, however, that more research is required. At the moment, it seems the procedure may work for women who have a sister who can provide suitable ovarian tissue or indeed a whole ovary, or for women who are about to receive cancer treatment and therefore know in advance that they are likely to become infertile. These women have the option of freezing their own ovarian tissue while they are still menstruating. Women who suffer from other conditions which are treated with cancer drugs, such as disorders of the blood, kidneys and joints, may also be candidates. Fertility doctors have also said that women who suffer from osteoporosis may find that their condition improves after the transplant induces menstruation.
Ethical Concerns
Some fertility specialists have suggested that the procedure could benefit women who do want children eventually but would like to postpone motherhood for social or career reasons. Such women could freeze their ovarian tissue and have it transplanted when they are ready to have children. Critics have questioned whether or not this is an ethically sound proposal and say that infertility specialists should be focusing their efforts and resources on couples who are genuinely infertile.
Womb Transplant
Permission was granted in 2006 to begin preparations for the world's first womb transplant. Fertility specialists say we may see the first baby born after a womb transplant sooner rather than later.
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