Scientists reverse menopause with ovary grafting

MEDICAL HISTORY Woman has fertility restored in revolutionary operation but doctors are cautious about prospects for widespread use

SCIENTISTS, WHO for the first time have reversed the menopause, said yesterday that it was too early to judge whether the pioneering ovary graft operation would help other women.

Roger Gosden, professor of reproductive biology at Leeds University, pioneered the technique that restored the fertility of a 30-year-old American woman. But he said the procedure was in its infancy and until someone became pregnant it was too soon to celebrate. "This is not a treatment for infertility but is purely a means of providing help for those who are about to lose their ability to have children," he said.

Other fertility specialists said hundreds of thousands of women could benefit from the breakthrough, which they believed would have a greater effect on human reproduction than all other treatment.

Thousands of female cancer patients who undergo treatment that makes them sterile, women with a family history of premature menopause, career women who want to have children later in life and those concerned about reducing the effects of ageing could have their lives transformed.

The procedure raises the prospect of all women storing their ovarian tissue in "banks" when they are young, with the view to extending their fertility and youthful looks into old age. The operation on Margaret Lloyd- Hart, a dancer from Tucson, Arizona, was carried out last February in New York, by Dr Kutlak Oktay, a former research fellow of Professor Godsen's.

Mrs Lloyd-Hart, who had both ovaries removed for medical reasons, had frozen some of her ovarian tissue when her second ovary was removed a few years ago. Surgeons grafted part of the tissue on to her pelvic wall near the ovary's original location. The ovary has recently been stimulated with hormones and she has now produced an egg. Doctors said there was a fair chance Mrs Lloyd-Hart would soon start producing eggs and menstruating normally.

There are plans to collect her eggs, to create embryos for storage so she can have her own children. Professor Gosden, 51, who is to present the findings at the American Society for Reproductive Medicine in Toronto next week, said: "It is true a woman's own ovarian tissue was returned to her body after frozen storage. But it is early days and we can't be sure how successful it will be or how many may benefit from it."

The operation has proved that ovary grafts can be used to rescue fertility and there was no reason why ovaries could not be stored for decades, he said. After a graft the ovary could continue to function long after the menopausal age. The ovaries produce the female sex hormones, oestrogen and progesterone, and contain cavities which allow eggs to develop.

Tony Rutherford, director of the reproductive medicines unit at Leeds General Infirmary, said: "We have been helping young women and children who are about to undergo cancer treatment that will destroy their ovarian function, in the hope that they can preserve their fertility in the future. It would be wrong to assume we can use this for anything other than young patients."

The breakthrough was welcomed by Professor James Drife, the junior vice-president of the Royal College of Obstetricians and Gynaecologists. "It is an important step forward," he said. "The main clinical application is on young girls and children who have to undergo cancer treatment, not the broader issue of women who go through natural menopause." A report examining the scientific and ethical implications is to be presented to the Royal College's ruling council tomorrow.

Deborah Orr,

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