BioEd Online

After receiving an ovarian transplant from her twin sister last April, Stephanie Yarber of Muscle Shoals, Alabama gave birth to a healthy baby girl earlier this week.

"Mother and baby are excellent," says Roger Gosden, a reproductive biologist at Weill Medical College of Cornell University in New York City.

The success story follows a number of recent achievements in the field. A whole-ovary transplant between sisters was reportedly performed in China in April 2002. And last year, a cancer patient in Brussels gave birth to a baby after having her own ovarian tissue frozen and then re-implanted after cancer treatment had made her sterile.

Achieving a normal pregnancy and birth from an ovarian transplant between different women is a first. Researchers say it is encouraging news for women who wish to restore their fertility. The procedure is likely to work only with genetically identical twins for the moment. But Gosden expects the procedure will become viable for others when more easily tolerated immunosuppressant drugs are created, as these stop the body rejecting implants.

In the meantime, say experts, in vitro fertilization remains the only option for most women. "For people without identical twins, egg donation is the way to go," says Kutluk Oktay, a reproductive endocrinologist at Weill Medical College of Cornell University in New York City.

Sister act

For unknown reasons, Yarber became prematurely menopausal at the age of 14. After two unsuccessful attempts at in vitro fertilization, Yarber's sister, who has had three children, agreed to donate an ovary to her identical twin. An ovary was removed from Yarber's twin and the 'skin' of the organ collected. A third of this tissue was frozen and the rest was grafted on to Yarber's ovaries.

Nearly three months later, Yarber got the first period she'd had in ten years and about three months after that she found she was pregnant.

"Conception was natural and pregnancy and delivery were completely normal," says Gosden, who is an author of the paper reporting the technique, published online in the New England Journal of Medicine¹.

Oktay says the study adds to evidence that it is sensible for some women concerned about their future fertility to have their ovaries preserved. "This study is a proof of principle for work with cryopreservation of ovarian tissue," he says. Frozen ovaries could be used to recover fertility in cancer patients, for example, whose chemotherapy may kill their eggs.