Retirement or Bust?

Baby after whole ovary transplant

A 39-year old woman has become the first to give birth following a whole ovary transplant. Susanne Butscher received an intact ovary from her fertile twin sister last year, during a landmark operation carried out by Dr Sherman Silber of the Infertility Centre of St Louis, Missouri US. Mrs Butscher became infertile after her ovaries failed at the age of 15. To date, eight
women have given birth subsequent to receiving small sections of ovarian tissue. Yet this - the ninth case - has been lauded as a pioneering achievement in infertility treatment.
The birth of baby Maja last week should be celebrated, according to Dr Silber, during what he has labelled an 'infertility epidemic' that in the UK alone is affecting upwards of 100,000 women. Although a complicated procedure (the operation involves the reattachment of arteries one third of a millimetre in diameter), the transplant renews the ability to conceive
naturally. It also restores hormone levels to those necessary for driving the menstrual cycle. Such hormones, like oestrogen and progesterone, also protect against osteoporosis.
Nonetheless, the majority of women affected by an early menopause are unlikely to have a fertile twin sister capable of donating an ovary. This would be necessary in order to avoid donor-rejection of foreign tissue, and to circumvent the need for immuno-suppressive drugs. But Dr Silber claims that, from a social perspective, it will be an attractive option for women
wishing to extend fertility into their forties and fifties, perhaps to favour a career. However the British Fertility Society (BFS) is opposed to what it calls an 'unethical application' of the operation, suggesting current methods, like egg storage, are less problematic. Laurence Shaw, consultant in reproductive medicine at the London Bridge Fertility Centre, London, and spokesperson for the BFS, said: 'I would have thought that the long-term freeze-storing of an ovary would cause as much harm as the deterioration due to age itself'.
The BFS instead endorses a more practical application of the operation. Women that face invasive cancer therapies like radiotherapy and chemotherapy (both of which reduce fertility) could have an ovary frozen pending an improvement in their condition. In such cases, ovary storage could be more suitable than egg extraction, as egg follicles must first be matured through a lengthy hormone treatment, causing unwanted delays to chemotherapy.