In August last year, IVF specialists in the UK made world headlines when they announced they were offering women the chance to outsmart our biological clocks – to keep menopause at bay and prolong our fertility by as much as 20 years. For those pushing 40 who are still hoping to have a baby (but are not yet with the right partner), or who dread the prospect of menopause and its infamous symptoms and health risks, it surely sounds too good to be true.
To date, at least 10 women, aged 22 to 36, have taken up the offer by Professor Simon Fishel, chief executive of ProFam and founder of the CARE Fertility Group in Birmingham. The procedure they’ve undergone is ovarian tissue freezing and grafting. It’s by no means new; it’s been offered for years to young cancer patients facing chemotherapy who want to preserve their fertility. But according to ProFam, this is the first project in the world to provide the procedure to healthy women, specifically to postpone menopause.
SO HOW DOES IT WORK?
‘The human ovary has a limited number of follicles that produce an egg and hormones during each monthly cycle,’ says Joburg-based reproductive medicine specialist Dr Chris Venter. ‘As you age, this number of follicles depletes, eventually resulting in menopause. So the young ovary is significantly more hormonally active than the older ovary.’
In ovarian tissue grafting, a piece of the egg-laden tissue is removed by laparoscopic surgery while you are as young as possible (ProFam will do it up to age 40). It’s sliced up and frozen, possibly for decades – ready to be thawed and transplanted back when needed, through similar surgery. If you hope to get pregnant, the slice will be regrafted on or near your ovary, where the mature eggs it releases can be picked up by your fallopian tubes for natural fertilization.
But if you hope simply to avoid hot flushes, night sweats and the other frequent fallout of menopause, it can be regrafted somewhere easier to monitor, where there’s a good blood supply – your forearm, even an armpit – to restore your dwindling sex hormones and stall The Change. Should you not want to keep having periods, it’s possible to have the lining of your womb removed with endometrial ablation; and should you not wish to get pregnant, you could have tubal ligation sterilization, says Joburg-based fertility specialist Dr Antonio Rodrigues, director of Medfem Fertility Clinic.
HOW EFFECTIVE IS IT?
It’s too early for any of the 10 women who have had tissue frozen by ProFam to have it regrafted. However, a study (‘Efficacy of ovarian tissue cryopreservation for fertility preservation,’ in the journal Human Reproduction, published in 2017) noted that while the procedure was still seen as experimental, some 86 babies had already been born after a transplant of thawed ovarian tissue. The ages of the women who gave birth were not noted, and there was limited follow-up on their or their babies’ wellbeing.
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