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Surgery that Puts Menopause on Hold

by Julia MedewThe Sydney Morning Herald
November 30th, 2012

Ovarian tissue transplants ... were once considered as a way for women in their 40s and 50s to preserve their fertility. Now IVF specialists say they will only offer this treatment to women whose fertility is threatened by illness.

OVARIAN tissue transplants could be used like egg-freezing to preserve a woman's fertility into her 40s and 50s but IVF specialists say they will only offer it to women whose fertility is threatened by illness such as cancer.

On Wednesday Monash IVF announced it had preserved a woman's fertility by taking ovarian tissue from her before she had breast cancer treatment in 2005, freezing it, and reimplanting it in her this year. It allowed the 43-year-old woman's body to resume natural ovulation.

Now six weeks pregnant, the Melbourne woman is the 20th in the world and the first in Australia to achieve pregnancy with the ground-breaking technique.

While the technique means menopause can be delayed or reversed, fertility experts said it was still too experimental to offer ovarian tissue freezing to women in their 20s and 30s who were not ready for pregnancy but wanted options in the future.

However, they said the technique, pioneered in Israel, offered hope to thousands of women with endometriosis and those at risk of early menopause. About one in 50 Australian women experience menopause before the age of 40 and about one in 10 women of reproductive age have endometriosis, a condition that can cause infertility.

The clinical director at Monash IVF, Lynn Burmeister said if women had surgery for endometriosis, their gynaecologist could take a small amount of ovarian tissue for freezing to give them the option of using it later. Women who have a strong family history of early menopause could also consider it.

''I've currently got an 18-year-old patient who is in menopause and occasionally we see it in women in their early 20s. It's devastating,'' said Dr Burmeister, who is looking after the 43-year-old breast cancer survivor who became pregnant through transplantation last month.

While some Australian women are paying about $12,000 to freeze their eggs because they are not ready to have a baby and want options in future, leading IVF specialists said they would not recommend ovarian transplantation for the same reason.

The vice-president of the Fertility Society of Australia, Michael Chapman, said although transplantation delayed menopause, there was no evidence yet that it could put menopause off indefinitely. ''The freezing and putting-back process destroys most of the eggs with the current technology but we've said that about a lot of things with IVF and the technology keeps getting better, so we'll be saying different things five years from now.''

Professor Chapman said the concept of young women having tissue frozen to reimplant it for pregnancy in their late 40s and 50s had to balanced against the risks of birth for women and their babies at such an age.

The director of Melbourne IVF, Lyndon Hale, said: ''If we're doing it for cancer we're doing it for a crisis, an identified need, whereas the rest of it is probably trying to fandangle nature too much."

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