Posted by Article on 9/26/2001, 11:37 pm

Ovarian Tissue Transplant May Preserve Fertility By Amy Norton NEW YORK (Reuters Health) - Transplanting ovarian tissue to the arm before cancer therapy may prevent premature menopause in younger women--and could possibly preserve their ability to have children, preliminary research shows. Researchers say the tactic also holds promise for women who have their ovaries removed due to non-cancerous conditions. In two patients--one with cervical cancer, the other with benign ovarian cysts--the investigators showed that relocating some ovarian tissue to the forearm prevented the permanent menopause that would have resulted from their treatment. The transplanted tissue preserved the patients' hormone production, but it is still unclear whether the procedure can protect women's fertility. However, the study's lead author told Reuters Health that if the tissue can produce normal hormone levels, there is a ``great chance'' it can produce viable eggs to be used for in vitro fertilization. Dr. Kutluk Oktay and his colleagues at Cornell University's Weill Medical College in New York report their results in the September 26th issue of The Journal of the American Medical Association (news - web sites). For women of reproductive age, premature menopause is one of the most common complications of chemotherapy and radiation treatment for cancer. Other women go through early menopause when they have their ovaries removed due to endometriosis or troublesome ovarian cysts, or when they receive chemotherapy for non-cancerous conditions such as lupus, Oktay noted in an interview. So he and his colleagues looked at whether moving ovarian tissue to the arm could preserve hormone and egg production in such women. The procedure involves removing the ovaries, then cutting the outer layer of tissue into strips, which are then implanted under the skin of the forearm. The cervical cancer patient in this study underwent radiation to the pelvis, so she was able to have her ovarian tissue transferred to the arm prior to cancer treatment. If a woman were receiving chemotherapy--which affects the whole body--the ovarian tissue would have to be frozen and implanted once the cancer treatment was over, Oktay explained. The other patient had suffered from recurrent cysts on her only ovary, despite having several operations to remove them. After the ovary was removed, strips of healthy tissue were relocated to the forearm. In both cases, the transplanted tissue was able to produce hormones like a normal ovary--although in the cancer patient, hormone levels were not high enough to trigger ovulation. She did, however, produce eggs with the help of drugs that stimulate the ovaries. The ovarian cyst patient began having normal periods about 6 months after the transplant, and her egg production started up again. With the exception of a ``little lump'' that appeared on one patient's arm for a few days each month, there were no obvious side effects, according to Oktay. The next step, he said, is to study the procedure in a larger group of women, and to see whether--in conjunction with in vitro fertilization--it can protect patients' fertility. SOURCE: The Journal of the American Medical Association 2001;286:1490-

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