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Thursday, 23 September, 1999, 12:18 GMT 13:18 UK
Ovary grafting
The technique could restore fertility to thousands of women
BBC News Online examines the possibilities, benefits and potential drawbacks of the world's first 'ovary graft' operation.

What exactly did doctors achieve?

Ovary tissue was taken from a 30-year-old woman and frozen, then reimplanted back into her body after she lost both ovaries.

Using fertility drugs, the ovaries were then stimulated into ovulation (the release of an egg), although the woman's natural menstrual cycle has not been restored as yet.

Hormones produced by the ovary tissue have also not yet removed many of the unpleasant symptoms of the menopause, such as hot flushes and fatigue.

What could this breakthrough lead to?

In theory, the successful transplant could lead to a wealth of different treatments for women young and old.

It could

  • Treat sterility caused by premature menopause
  • Restore fertility in patients made sterile by cancer treatment
  • Delay the onset of the menopause in older women, allowing them to have babies

It is seen by some as an alternative to hormone replacement therapy (HRT), which can improve the quality of life of older women.

However, although effective in reducing menopausal symptoms, HRT has been linked with an increased risk of cancer.

Although the treatment has only been involved in the transplantation of a woman's own ovarian tissue, it is hoped that donor tissue could eventually be used.

What are the potential limitations?

Whether this technique will become widely used is uncertain, as it involves surgery first to remove the tissue and then re-implant it, which can be risky.

The technique at present cannot help a woman unless she has had the opportunity to freeze some tissue in advance.

And there is still no guarantee that the graft will lead to result in a successful pregnancy.

What ethical worries does it raise?

This development could be as controversial as the issue of egg donation and in-vitro fertilisation (IVF).

There is currently a ban on using human foetus tissue
The present use of tissue, to restore fertility in women who have suffered premature menopause is similar to the concept of men freezing sperm before undergoing treatment which threatens their fertility.

Equally uncontroversial is using one's own frozen tissue as a substitute for HRT.

More likely to provoke debate is the concept of far older women becoming capable of carrying children.

Many fertility experts are against offering treatment to older women due to the far higher risks to mother and child during pregnancy, and the possibility that the mother will be too old to properly care for the infant.

Also controversial would be any attempt to use tissue from donors, or even aborted foetuses.

Is there any way of controlling who gets treatment, and why?

At the moment, no, as the Human Fertilisation and Embryology Authority (HFEA), which oversees fertility issues for the government, only covers the use of mature eggs and sperm, not the immature eggs contained in ovarian tissue.

However, Parliament has imposed a ban on the use of foetal tissue for restoring fertility.

The doctors behind the technique are working on voluntary guidelines on the use of ovary grafts, and the Royal College of Obstetricians and Gynaecologists is expected to release guidance later this week.

However, these, and even the rulings of the HFEA - should it be allowed to cover the issue - could be subject to legal challenge by a woman who was turned down for the treatment.

Diane Blood managed to overturn an HFEA decision forbidding her from using her dead husband's sperm for IVF treatment.

See also:

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23 Sep 99 | Medical notes
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