Ovary Transplants: Are They Possible?

Yes, ovary transplants are now possible but the whole issue of whether they are a good idea was highlighted in the autumn of 2008 when a 38-year old woman became the first ovary transplant recipient to give birth to a baby. This sparked off several articles online and in newspapers claiming that this was women at their most selfish, that the new technique would allow women in their twenties to have one of their ovaries removed and frozen, to be transplanted later when their whims and careers dictated that they were ready for motherhood.

Why Women Would Need an Ovary Transplant

But is any of this true? As with many sensationalist reports, not really. It is true that it could become possible for a woman to have one ovary removed and frozen to be transplanted later but there are much more serious reasons why this would be necessary. Many women go through the menopause early – the woman who gave birth last year had suffered premature menopause at the age of 15. She had been completely infertile since then. Her twin, who already had two children, donated her sister one of her ovaries and the delicate operation was a success. She conceived the child she had longed for, for 20 years, just a year later.

Many other women lose their ovaries after radiation treatment that saves them from cancer. Others have kidney transplants or other organ transplants and the immunosuppressive therapy destroys the function of their ovaries. In total, more than 100 000 women are destined to be infertile because of ovary problems. If women were able to have an ovary removed before treatment, this would restore their fertility after treatment, allowing them to have a family.

What Does an Ovary Transplant Involve?

The operation is still quite experimental and is very specialised. In the few operations that have been done, the transplant has been between identical twins, which limits the problems of rejection. For a woman to donate an ovary to an unrelated women, they would need to be closely matched, as happens with other organ transplants.

The ovary is removed by keyhole surgery, so the recovery time for the donor is fairly quick. The ovary, which looks a bit like a walnut is then implanted using a more open surgery technique in which the tiny blood vessels are reconnected so that the transplanted ovary gets an adequate oxygen supply. This vascular part of the operation is the most delicate and takes the longest.

When the transplant is completed, it takes a few months for the ovary to start functioning normally but in the twins studied so far, hormone production seems to reach normal levels within about 5 months. The twin who gave birth last year found that her periods returned for the first time in 22 years and her osteoporosis showed signs of improvement, once her hormone levels stabilised.

Future Possibilities for Ovarian Transplant

The technique is still very much in its early days but could become more routine in the future as it would help so many women. The vascular surgery needs to be done by a very experienced surgeon, as the vessels that need to be reconnected are, in some cases, only a fraction of a millimetre in diameter. It is also possible to transplant strips of ovarian tissue and several women who have received this type of transplant have become pregnant successfully.