Posted on 09/23/2004 9:18:11 PM PDT by neverdem
A 32-year-old woman in Belgium has become the first woman ever to give birth after having ovarian tissue removed, frozen and then implanted back in her body, doctors are reporting.
The patient had the tissue removed in 1997 in hopes of preserving her fertility because she had Hodgkin's lymphoma, a type of cancer, and was about to undergo chemotherapy with drugs likely to damage her ovaries and cause infertility. She and her doctors hoped that once she was cured, the ovarian tissue could be thawed and returned to her abdomen to produce eggs.
The strategy apparently worked. The woman, Ouarda Touirat, became pregnant without medical help and gave birth yesterday to an 8-pound 3-ounce daughter, Tamara, at St. Luke's Hospital in Brussels. Both the mother and baby were healthy, a hospital spokeswoman said.
The case reflects a success story in cancer treatment: cure rates for cancers in children and young people have increased enough so that it is realistic to worry about whether survivors will be able to have children of their own one day.
The team in Brussels, led by Dr. Jacques Donnez, wrote in their report that their ovary-freezing technique should be offered to all young cancer patients who must undergo treatments that might leave them infertile.
But other experts in the field said the procedure, which must still be considered experimental, was not the only option, and not necessarily the best option, for all girls and women.
A report on the case was published online last night by The Lancet, a British medical journal. But the doctors declined interviews, saying through a hospital spokeswoman that they would not speak to reporters before a news conference today.
Not all chemotherapy causes women to become infertile; the effects vary with drugs and doses, and individual sensitivities.
When infertility is likely, patients have several options, depending on their age, whether they have a partner with whom they want to have children and how quickly they must start chemotherapy.
Fertilized eggs survive freezing and thawing better than unfertilized ones do, so the best chances of success come from in vitro fertilization. In that procedure, before chemotherapy, a woman is treated with hormones so that she produces multiple eggs at once, which are then fertilized with sperm from her partner or a donor and frozen.
Women who do not have partners and do not wish to use sperm from a donor can have eggs collected and frozen, but success rates are relatively low and the procedure is considered experimental.
Women who have either eggs or embryos frozen might want to consider having some ovary tissue frozen as well, just as an extra bit of insurance, said Dr. Zev Rosenwaks, director of the center for reproductive medicine and infertility at Weill Cornell Medical College and New York Presbyterian Hospital. Dr. Rosenwaks was not involved in the Belgian study, but is conducting similar research.
In some cases, eggs cannot be harvested. A girl may be too young, the type of cancer might make it unsafe to undergo the hormonal treatment needed to cause ovulation, or the patient might need to start treatment quickly because of the aggressiveness of the cancer. In those instances, it may make sense to freeze ovarian tissue, because the procedure can be done quickly and does not require hormone treatment.
The patient in Belgium was 25 when she had to have chemotherapy. Doctors removed strips of tissue from one ovary, but did not want to remove the entire ovary, in case it could survive the chemotherapy. After the chemotherapy, her menstrual periods stopped and hormone tests indicated that she had gone through premature menopause.
About five years later, when she wanted to become pregnant, doctors performed surgery to return the tissue to her abdomen. Eleven months later, she became pregnant.
The doctors say it is almost certain that the egg came from the transplanted tissue rather than her ovaries themselves, because the ovaries hardly functioned, while the tissue did have maturing eggs that could be seen. But it is impossible to be absolutely certain that the egg came from the tissue.
Dr. Roger Gosden, a pioneer in reproductive biology who now works with Dr. Rosenwaks, said, "We always thought this technique would work."
But, Dr. Gosden added: "How do you know that a woman is going to be sterilized? We are often very unsure. We have to be a bit cautious and not put women through an unnecessary procedure. This must still be considered experimental."
Dr. Gosden predicted that the technique would be more successful in very young women than in those over 35, because older women have fewer eggs.
Dr. Jeanne Petrek, a breast cancer surgeon at Memorial Sloan Kettering Cancer Center, said she was studying about 800 women 44 and younger who had undergone chemotherapy. After five years, Dr. Petrek said, about half were still menstruating.
She said she thought the tissue-freezing procedure would be used more by young women and girls with leukemia or lymphoma, because their treatment is more likely to cause sterility than treatments for breast cancer.
ping
No mention of a husband. Hope there is one for the baby's sake.
"But it is impossible to be absolutely certain that the egg came from the tissue."
So what`s the hype about?
With a name like Ouarda Touirat, I'd be surprised if she has an all Belgian ancestry and believes in a Christian religion. I'm inclined to think she's a Muslim, most of whom frown greatly upon births out of wedlock. Anyway, this is the NY Times. Men aren't worthy of comment.
If it's not from the implant, then it's spontaneous ovulation from what had been menopausal ovaries secondary to prior chemotherapy.
They are having a photo op today (FRI) at the hosptial. They say "parents" so somebody is gonna be there.
Re: Frozen eggs
Wired article: "Frozen Eggs Showing Promise"
http://www.wired.com/news/medtech/0,1286,64916,00.html
As for the surgery, I am quite pleased to here that this is an option.
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