How Ovarian Tissue Freezing Could Prevent Menopause - Possibly Forever
Most women agree that menopause has its advantages and disadvantages. Some relish the end of menstruation and concerns about unplanned pregnancies, while others dread the possibililty of hot flashes, moodiness, and other unpleasant symptoms.
Now, a new paradigm around the biological processes of menopause is capturing the attention of a small group of scientists around the country. The primary question: can menopause be delayed in healthy women, allowing them to extend their child-bearing years—and perhaps even forestall some of the health risks and uncomfortable symptoms linked to plummeting estrogen levels? These questions can be controversial: Some people believe that such research could lead to life-changing benefits for women, while others consider menopause to be a biologically driven life stage that should not be pathologized by medical science.
At Yale School of Medicine (YSM), Kutluk Oktay, MD, PhD, an ovarian biologist who is director of the Laboratory of Molecular Reproduction and Fertility Preservation, recently added a new chapter to this conversation by publishing research on various possible outcomes when menopause is delayed in healthy women via ovarian tissue freezing.
Oktay, who developed and performed the world’s first ovarian transplant procedure with cryopreserved tissue for a patient with a medical indication in 1999, sees a future in which healthy women could use this process of freezing tens of thousands of eggs within the ovarian tissue to stave off menopause for as long as several decades—or even prevent its onset altogether.
“For the first time in medical history, we have the ability to potentially delay or eliminate menopause,” said Oktay, who is also an adjunct professor of obstetrics, gynecology & reproductive sciences at YSM.
A mathematical model predicts outcomes for delayed menopause
Using data from hundreds of previous ovarian cryopreservation and transplantation procedures, and molecular studies of how ovarian follicles behave in ovarian tissue, Oktay and his colleagues built a new mathematical model, published in the American Journal of Obstetrics & Gynecology, to predict how long the surgery could potentially delay menopause under a range of circumstances in healthy women.
Since Oktay performed the first successful transplantation with cryopreserved tissue, ovarian tissue cryopreservation has been successfully used in cancer patients to preserve their fertility before their treatments, which can often permanently damage the egg reserve in the ovaries and trigger menopause. During this outpatient procedure, a surgeon laparoscopically removes the whole ovary or layers of the outer portion, which contains hundreds of thousands of dormant, immature eggs (known as primordial follicles).
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