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Wednesday, 24 February, 1999, 18:21 GMT
Ovary tissue breakthrough
Freezing ovarian tissue could prevent it being damaged by chemotherapy
A 29-year-old US woman has had her ovarian tissue removed and reimplanted in what is claimed to be the first operation in the world of its kind.

If successful, the surgery could help thousands of women whose fertility is threatened by chemotherapy.

Magaret Lloyd-Hart of Arizona had one ovary removed at the age of 17 after she developed a cyst.

The second was taken out and frozen last year before she underwent an operation for an unspecified benign medical condition.

Ms Lloyd-Hart later regretted the decision to have her ovary removed, but fortunately had had the tissue frozen.

Internet

Using the Internet, she managed to find out information about her condition.

She also discovered that sheep and mice that had had ovarian tissue removed and frozen had had their reproductive functions restored at a later date.

Finally, she tracked down Dr Kutluk Oktay at New York Methodist Hospital in Brooklyn.

He agreed to reimplant her ovarian tissue after the two had exchanged letters for 10 weeks.

Ms Lloyd-Hart flew to New York with 72 vials of ovarian tissue in the seat beside her.

Doctors only used 60 vials in the operation which took place last week and is claimed to be a world first by the hospital.

The remainder of the tissue is being saved in case it is not successful or Ms Lloyd-Hart needs further grafts in the future.

Experiments on sheep

Dr Oktay, director of reproductive endocrinology in the Department of Obstetrics and Gynaecology at the hospital, said the operation had a 40-50% chance of a good result.

He stated that the best marker of success would be if Ms Lloyd-Hart began to have normal monthly periods.

This had occurred in experiments on sheep.

Ms Lloyd-Hart said her main concern was to get her endocrine system working properly.

She added that her "whole body was in shock" after her second ovary was removed.

The removal of ovaries leads to early menopause.

Ms Lloyd-Hart said she had tried hormone replacement therapy to offset some of the symptoms of early menopause, but it had not worked well.

"It does not do the job as well as your own body does," she said.

Experimental

Dr Oktay is a former research fellow of Professor Roger Gosden of Leeds Royal Infirmary.

Professor Gosden says he believes the operation, which he calls "experimental", is the first of its kind to reimplant frozen ovarian tissue.

But he says it is too early to know whether it will be successful.

"We should know in six months to a year," he said.

The main concern was whether the tissue had been properly frozen to allow the follicles which contain the eggs to survive in sufficient numbers to ensure fertility.

Ovary transplants have been attempted since the beginning of the century, but have hit complications.

In Ms Lloyd-Hart's case the ovary tissue comes from her own body so there is no danger of rejection.

However, Dr John Toy of the Cancer Research Campaign said eggs and sperm which had been frozen are not as viable as fresh ones.

And ovaries are more complex than eggs. Moreover, some young women with cancer were only temporarily affected by chemotherapy, with their ovaries eventually coming back to life.

For older women, the early menopause caused by chemotherapy might help reduce the possibility of cancers like breast cancer returning.

But for younger women he said the US operation was "a very interesting development".

Professor Gosden said that, if successful, the reimplantation operation could help women who were being treated with chemotherapy for cancer and other conditions, such as blood diseases.

It could also help women with other gynaecological conditions such as endemetriosis, some young women with a family history of early menopause and, more controversially, for women who wanted to delay pregnancy.

The Royal College of Obstetricians and Gynaecologists has set up a working group to look at the ethical and technical implications of freeze banking testicular and ovarian tissue.

See also:

24 Feb 99 | Health
The future of frozen fertility
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