Physicians for the first time have successfully transplanted an intact ovary into a previously infertile patient, resulting in a live birth last month, doctors from the Infertility Center of St. Louis reported on Thursday in the New England Journal of Medicine, Reuters reports. The researchers said the new technique potentially could be used to preserve fertility for cancer patients who may lose ovarian function or for women who wish to have children later in life, when they are less fertile. Sherman Silber of the infertility center and colleagues transplanted a woman's entire ovary into her 38-year-old identical twin sister, who had experienced premature menopause at age 15. The ovary restored full fertility in the sister, they reported.

The researchers previously had performed transplants using only the outer shell of the ovary, and they found that the tissue was able to restore fertility, even if the transplanted ovarian tissue had been frozen. However, two-thirds of the eggs died from a lack of blood flow through the tissue. In addition, although such transplants have led to live births for eight women, the women experienced menopause after about three years. Using a new technique, the researchers transplanted a complete ovary, connecting two veins and one artery to feed the graft -- a challenge because of the small size of the blood vessels.

Silber said the new technique eventually could benefit two groups of women if the method is found to be viable using a woman's own previously frozen ovaries. He said one group would include "the young cancer patient who is about to lose all her ovarian function as she's about to undergo chemotherapy. We just take the ovary out, freeze it and transplant it back." The technique also could benefit women in their 20s who foresee delaying pregnancy until later in life and choose to have an ovary removed and frozen for future use, which Silber said is controversial. "If she's 40 or 45 when she has it transplanted back, it's still a 25 or 35-year-old ovary, so she's preserving her fertility," he said, adding, "We've actually done it for quite a few patients. I think there will be many more women who will want to do that." The infertility rate is about 6% at age 25 and increases to 70% at age 40 and to 95% at age 43, according to Silber (Emery, Reuters, 12/10).

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