Introducing Tamara, medical miracle baby
Saturday 25 September 2004
"It is a dream" said Ouarda Touirat, smiling at the cameras yesterday. The first woman in the world to give birth following an ovarian transplant cradled her new-born baby and added: "It is what I have always wanted."
The Belgian woman presented her daughter, Tamara, to the world's press less than 24 hours after her birth on Thursday night. She had made medical history after becoming infertile through cancer treatment in 1997. Doctors at the Catholic University of Louvain in Brussels removed one of her ovaries before the treatment began and froze the tissue before transplanting it back into her body seven years later. The success of the technique offers hope to thousands of women with cancer who may now be able to preserve their fertilityby banking their ovarian tissue before starting treatment.
Professor Jacques Donnez, who led the medical team responsible for the transplant, said 146 women under his care were having the same procedure. A second woman had had frozen tissue from her ovaries transplanted back into her body three weeks ago but it was too early to say whether she would recover her fertility, Professor Donnez said.
The development also raises difficult ethical questions as it brings the possibility of women extending their reproductive lives into their fifties, sixties or beyond. The professor ruled that out. "There are ethical difficulties. This technique must be reserved for young women with cancer. I will never propose this for a woman of 25 with the goal of re-implanting at 55," he told Sky News yesterday.
For Ms Touirat, 32, the birth marks the end of seven years of hope and despair. "I was crying at first, it's ... a big miracle," she said with her husband, Malike, 40, at her side.
The couple had been expecting their first baby when Ms Touirat was diagnosed with Hodgkin's lymphoma in 1997 at the age of 25. That pregnancy had to be terminated because she needed chemotherapy and radiotherapy that would have been fatal for the baby anyway.
When she was declared cancer-free last year, the frozen ovarian tissue was thawed and reimplanted just below her remaining ovary. Five months later her menstrual cycle was restored and in January she became pregnant after conceiving naturally. When news of her pregnancy broke in June, she said: "I am ecstatic. I am over the moon. I can hardly wait."
Women with cancer have few options for preserving fertility. Men can easily have their sperm frozen but eggs do not survive thawing so well. Transplanting ovarian tissue therefore offers new hope. Researchers cut 12-15mm-long and 5mm-wide samples from one of the two ovaries and froze them in liquid nitrogen. "Several lines of evidence lend support to our assertion that the origin of the pregnancy was the autotransplanted ... tissue," the researchers wrote in The Lancet.
Kutluk Oktay, a reproductive endocrinologist from Cornell University in New York, was cautious. Although he was not involved with the operation, Dr Oktay has conducted much of the key research in the field. He said: "It cannot be proved with 100 per cent certainty [that the pregnancy came from the graft] because ovulation from the transplant was ...calculated from temperature but was not confirmed. Even though the woman's remaining ovarian tissue stopped working after the cancer treatment, it recovered and she ovulated three years later, which indicates it is possible that the native ovaries could have ovulated again to produce the baby."
Dr Virginia Bolton, a consultant embryologist King's College Hospital, London, and spokeswoman for the British Fertility Society, said: "This is wonderful news for women who face the terrible prospect of becoming sterile from life-saving cancer treatment. With this development comes the real chance for them of having ... their own baby."
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