IN A transplant operation never before performed in the west, a woman has received a new ovary donated by her sister. While the surgeon responsible claims this holds out hope for women without functioning ovaries, others say the procedure is dangerous and unnecessary. The woman could have got pregnant using a donor egg and her husband鈥檚 sperm, and had any premature menopause postponed by hormone treatments, the critics say.
鈥淭he hope is that transplanted whole ovaries may be able to work for as long as a woman鈥檚 own ovaries鈥�
Sherman Silber removed an ovary from Maeapple Chaney and transplanted it into her sister, Joy Lagos, at St Luke鈥檚 Hospital in St Louis, Missouri, on 5 February. All Lagos鈥檚 eggs had been destroyed when she was given chemotherapy treatment for cancer three years ago.
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In 2002 surgeons at China鈥檚 Zhejiang Medical Science University reported a whole-ovary transplant between sisters, though the transplant was never documented in the scientific literature and its long-term success is not known. Since 2004, Silber has transferred grafts of ovarian tissue between seven sets of identical twins, resulting in at least one live birth from the transplanted graft (New Scientist, 23 October 2004, p 12). These grafts usually only produce eggs and reproductive hormones for a few years, Silber says.
He believes that transplanted whole ovaries may be able to work for as long as a woman鈥檚 own ovaries, while transplanting a whole ovary may also make it less likely to be rejected than a graft, because it is less prone to inflammation. This could widen the range of possible donors to at least include close relatives, and not just twins, he says.
However, fertility specialists have questioned Silber鈥檚 claims that the ovary would be less likely to be rejected than a graft and say it is too soon to judge whether his latest operation has been successful. 鈥淭he patient could reject the ovary at any time. The ovary could clot next week,鈥� says Tommaso Falcone of the obstetrics and gynaecology department at the Cleveland Clinic in Ohio. 鈥淲e just don鈥檛 know the long-term consequences.鈥�
