A St. Louis fertility specialist is set to perform a transplant
today that may
be the ultimate "gift of life."
Dr. Sherman J. Silber,
director of the Infertility Center of St. Louis at St.
Luke's Hospital, will transplant an ovary from an Alabama
woman to her
infertile identical twin. It is the first time such a transplant
has been tried
in the United States, Silber said.
The sisters, Melanie Morgan
and Stephanie Yerber, 24, share the same genetic
makeup, with the possible exception of one or more genes
controlling the start
of menopause, Silber said. Both twins entered puberty normally,
but Yerber
began to go through menopause at age 13 while her sister
stayed fertile.
Collaborators at the Paternity Testing
Corp. in Columbia and at the MIT
Whitehead Institute will examine the sisters' DNA for
small differences that
could be linked to reproduction. The analysis could lead
to new insight on the
genetic cause of menopause, Silber said.
Silber transplanted
a testicle from one twin into his brother in
1977. The formerly infertile brother now has four children.
Several other
testicular transplants in the 1970s convinced Silber
that he could do the same
for female twins. But such cases arise rarely, he said.
The procedure is a last-ditch attempt for Yerber to become
pregnant. Morgan,
who has three children of her own, donated eggs for in
vitro fertilization
attempts several times. None of those tries resulted
in pregnancy.
 |
| Dr. Sherman J. Silber talks Tuesday with Melanie Morgan
(left) and her twin sister, Stephanie Yerber, who will
get an ovary from her sister in a procedure planned for
today by Silber. Morgan has had three children. Yerber
went through an early menopause and has been unable to
get pregnant. |
So the sisters sought out Silber and asked
him if he could transplant an ovary
from Morgan into her infertile sister. The doctor agreed
to try the unusual
surgery. Because the women are twins, Yerber will not
need to take
immune-suppressing drugs. Even closely matched siblings
would usually require
the drugs to stop the recipient's body from rejecting
the transplanted tissue,
he said.
Ovarian transplants are not completely new. Scientists
have been working for
years to learn how to freeze eggs and preserve a woman's
fertility - so far
unsuccessfully in humans.
Scientists at the Oregon Health & Science
University reported last month in the
journal Nature that a baby rhesus monkey was born after
a successful ovarian
transplant of the mother's own tissue to another part
of her body.
That technique holds hope for women who face
chemotherapy and would like to
freeze their ovaries. The organs are usually transplanted
in the arm, near the
kidneys or in other parts of the body. As a result, doctors
must harvest eggs
from the transplanted ovary and fertilize them in the
laboratory before
transferring the embryo to the mother's womb.
No babies
have been born from that process. But the technology has
advanced
enough so that doctors can coax frozen, thawed, transplanted
ovaries to produce
hormones again.
If Morgan's transplanted ovary functions
properly, it could produce significant
health benefits for Yerber by eliminating the need for
hormone replacement
therapy, Silber said. Hormone therapy has been linked
to an increased risk of
stroke, heart attack, breast cancer and Alzheimer's disease
in women who take
the drugs after menopause.
Silber will transplant the ovary
in place of one of Yerber's own defunct
ovaries. In about three months, Silber expects the ovary
to start normal
hormone cycles and produce mature eggs, ones that are
ripe for pregnancy.
"
The whole idea of this is a natural pregnancy," he
said.
Front Page - St. Louis Post Dispatch
April 21, 2004
