Chance To Pause Biological Clock With Ovarian Transplant Stirs Debate
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Today in Your Health, a new study shows boys are reaching puberty earlier and earlier. We'll hear that in a moment. First, a procedure that's being offered to women who want more time to have children. It involves freezing at least part of an ovary. As NPR's Rob Stein reports, there's a debate about who should be going this far to try to prolong fertility.
ROB STEIN, BYLINE: When Sarah Gardner was 34, she started getting really worried about whether she'd ever have kids.
SARAH GARDNER: I bought this kit online that said that they could tell you your ovarian reserve.
STEIN: These kits claim they can tell women how long their ovaries will continue producing eggs, how much time they have left to get pregnant.
GARDNER: Well, mine said we advise really you have a baby now. Well, sadly, that letter arrived three weeks after I'd just split up with my long-term partner. So, yeah, I mean, it opened a massive can of worms really.
STEIN: That can of worms eventually led Gardner to Dr. Sherman Silber in St. Louis. He's an infertility specialist who offers women a procedure that he says basically puts their biological clocks on ice.
GARDNER: It stops the clock, which is an incredible power to have. You know, the biological clock is every woman's demon, really.
STEIN: Silber describes it this way.
DR. SHERMAN SILBER: We can take the ovary out of a young woman, or part of an ovary out of a young woman, and we can freeze it. And when she's 51 years old we can transplant that tissue that's been frozen for the last 20 or 25 years and lo and behold, she's got a 20-year-old ovary and it'll last for another 50 years.
STEIN: Now, all this may sound good. But it's really controversial. The procedure was developed for women with medical problems that would damage their ovaries - mostly cancer patients getting chemotherapy.
GLENN SCHATTMAN: It is not a procedure that should be done electively for women to preserve fertility just to reduce the natural aging process and the decline in fertility as women age.
STEIN: Glenn Schattman's president of the Society of Assisted Reproductive Technology.
SCHATTMAN: It really should be reserved for patients that are at imminent risk of losing their fertility in the very near short term.
STEIN: That's because cancer patients really have no other options. No one really knows how well it works for other women, especially years, or even decades, later.
SCHATTMAN: We know there are 21 pregnancies that have been achieved in the world. We don't know what the denominator is. We don't know how many procedures have been done to achieve those 21 pregnancies.
STEIN: The only women who have gotten pregnant with an ovarian transplant are cancer patients. And Silber's one of a handful of doctors offering this to patients just trying to beat their biological clocks. Now, the surgical procedures and the freezing and thawing are relatively safe and easy. But any procedure carries risks. And Schattman says some eggs are lost.
SCHATTMAN: When you transplant the tissue back into somebody, you are going to lose some of the eggs in the ovarian tissue. And so you are aging the ovarian tissue.
STEIN: For all these reasons, Schattman and other infertility experts recommend women worried about preserving their fertility do something else - just freeze some of their eggs.
SCHATTMAN: We have a known success rate with egg freezing. We do not have a known success rate with ovarian tissue freezing.
STEIN: Dr. Kutluk Oktay agrees. He's a infertility expert at New York Medical College.
DR. KUTLUK OKTAY: If we convince ourselves that this procedure guarantees our fertility for the future we may say, well, OK, then let me just take the next eight years and take this degree and finish this project, you know, open up a new business because I have this guarantee. And then in the end it turns out that actually that guarantee was not there.
STEIN: But Silber in St. Louis says the success for cancer patients makes it clear the procedure would work for other women as well.
SILBER: If you say that we don't have evidence for ovary freezing working and that it's experimental, that's kind of baloney. It is not experimental anymore. It really is a very robust procedure.
STEIN: Silber argues it avoids the risks of egg freezing, like having to inject women with lots of powerful hormones. For her part, Sarah Gardner tried egg freezing, but it didn't work out for her. So she was happy to have the opportunity to pay $8,000 to freeze one of her ovaries.
GARDNER: It took a lot of pressure off, you know, that whole having to find the guy and get it done, you know, and get to have children. And there is no time limit for me now. They can defrost it at any point and put it back in.
STEIN: Gardner knows there are no guarantees. That after all this, it may not end up working. But for now, she's just grateful for the hope that it might.
Rob Stein, NPR News.
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