A US woman who became pregnant following an ovary tissue transplant from her twin sister has given birth to a baby girl. Stephanie Yarber, who went through the menopause in her teens, received part of an ovary from her identical twin sister Melanie in April 2004. Doctors removed tissue from one of Melanie's ovaries, divided it into three parts, and grafted two of those parts onto one of Stephanie's failed ovaries. The third part was frozen in case it was needed in the future.
Stephanie underwent premature menopause at the age of 13 - her ovaries stopped functioning and she became infertile. She and her husband tried a number of times to have a child both naturally and using IVF, including two cycles using eggs donated by her twin sister Melanie, but without success. Melanie was not affected by premature menopause and has three children conceived naturally.
Doctors have been working on ovarian transplantation techniques for a long time. As with other forms of organ or tissue transplants, one of the main problems is rejection by the body's immune system. So transplanting ovarian tissue from an unrelated woman would require the use of immunosuppressant drugs, which may themselves affect ovulation and fertility. For this reason, it is unlikely that there will be many ovarian transplants between women. But identical twins, who share the same genetic information, are much better candidates for donating ovarian tissue.
Dr Sherman Silber, who led the team that carried out the transplant at St Luke's Hospital in St Louis, Missouri, said the technique offered hope for many women affected by loss of fertility. 'The demonstration that ovarian function can be restored and that natural conception and successful pregnancy can be achieved after transplantation of ovarian tissue may have broader implications for young women, such as those who require potentially sterilising treatment for cancer', he said.
UK expert Allan Pacey, secretary of the British Fertility Society, agreed that knowing how to successfully graft back a piece of ovary frozen before cancer treatment would be of 'great benefit' to women diagnosed with cancer at an early age. However, he stressed that transplanting ovary tissue from one woman to another was likely to remain 'very, very rare, and not without risk to either party', adding that 'for the majority of cases, egg donation would be a much easier and safer option'.