This new surgery comes from a Birmingham-based company called ProFaM (Protection of Fertility and Menopause), co-founded by four world-renowned experts in reproductive medicine.
Experts say that this operation could benefit thousands of women who experience serious health problems caused by menopause, such as osteoporosis or heart infections. In the same way, the procedure would delay the appearance of the most frequent symptoms of menopause, such as hot flashes or reduced libido.
Delay menopause
The intervention, which costs between 7,600 and 12,000 euros, can be carried out in women up to 40 years of age at ProFam, which includes Simon Fishel, one of the pioneers of in vitro fertilization and president of the Fertility Care Group in the United Kingdom. So far, nine women have frozen ovarian tissue for when they are older.
The operation lasts 30 minutes and involves minor surgery to remove a small piece of ovarian tissue, which is then cut into slides and frozen for preservation . Upon entering the menopausal stage, the tissue thaws and grafts back into the body. As long as the ovarian tissue survives the process, it should restore the woman’s declining sex hormones and delay menopause.
How long to menopause?
Fishel notes that it depends on how old the tissue is removed and when it is put back in. For example, it suggests that ovarian tissue from a 25-year-old could postpone menopause for 20 years, while tissue from a 40-year-old could delay its onset for five years.
The specialist adds that while many will benefit from hormone replacement therapy, it may not suit all women.
Reactions
In response, the British Menopause Society stated that more research needs to be done to evaluate the safety of the technique. British Menopause Society President Haitham Hamoda stated that: “This report explores a potentially promising concept for women at risk for medically or surgically induced menopause. However, when it comes to considering it in the context of delaying menopause, Further evaluation is needed to examine the safety of this technique, its effectiveness, and how long the reimplanted tissue continues to function. Such an evaluation should also include a benefit / risk analysis, particularly when applied to healthy women. “
Professor Richard Anderson, Elsie Inglis Professor of Clinical Reproductive Sciences and Head of the Obstetrics and Gynecology Section at the MRC Center for Reproductive Health, University of Edinburgh, who was not involved in the study, commented:
“ Ovarian cryopreservation for subsequent replacement has been carried out for many years around the world, generally for young women facing loss of ovarian function as a result of cancer treatment. The focus has been on restoring fertility, as eggs are not as replaceable as hormones. There are now several hundred women around the world who have had their ovarian tissue replaced, and almost all of them show hormonal activity.
“So it is ‘old news’ that ovarian transplants can provide hormone replacement, but what is less clear is whether this is a safe and effective way to do it. Just remember the epidemic of endometrial cancer. after the introduction of estrogen-only HRT ( hormone replacement therapy ), it led to the recognition that progesterone was an essential component in making HRT much safer – we need similar data on ovarian transplantation before it can be considered a safe option for women. “
For her part, Melanie Davies , president of Fertility Preservation in the United Kingdom, who was also not involved in the study, said:
“Women experiencing menopause should take unbiased and professional advice. Ovarian tissue freezing has the role of preserving fertility in patients undergoing chemotherapy or radiotherapy where there is not enough time, or they are too young, for ovarian stimulation for egg / embryo freezing. But ovarian tissue is NOT a “preferred method” of preserving fertility, and it has no proven benefit for healthy women in “delaying menopause.”
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Beyond postponing menopause, doctors believe the procedure could save health services substantial amounts of money by reducing the costs of treating menopause and more serious related problems. But it could also be a game changer for fertility treatment. Unlike IVF, the preservation of ovarian tissue does not require drugs to stimulate the ovaries, and it is likely to produce many more eggs. Fishel says that if women in their 20s routinely stored ovarian tissue, they could have access to thousands of eggs if they later decided to have children. In fact, they could have a part of their tissue reimplanted to restore their fertility before starting a family, and the rest reimplanted later to stop menopause.
