New medical procedure could delay menopause by 20 years

This article was taken from: https://www.theguardian.com/science/2019/aug/04/medical-procedure-delay-menopause

By Ian Sample Science editor

Operation could benefit thousands of women who experience serious health issues

A medical procedure that aims to allow women to delay the menopause for up to 20 years has been launched by IVF specialists in Britain.

Doctors claim the operation could benefit thousands of women who experience serious health problems, such as heart conditions and bone-weakening osteoporosis, that are brought on by the menopause.

But the specialists believe the same procedure could also improve the lives of millions more women by delaying the onset of more common symptoms of the menopause, which range from low mood, anxiety and difficulty sleeping, to hot flushes, night sweats and a reduced sex drive.

The procedure, which costs between £7,000 and £11,000, is being offered to women up to the age of 40 through ProFam, a Birmingham-based company set up by Simon Fishel, an IVF doctor and president of the UK Care Fertility Group, in collaboration with other specialists.

“This has the potential to be of significant benefit to any woman who may want to delay the menopause for any reason, or those women who would have taken HRT, and there are lots of benefits around that,” Prof Fishel told the Guardian.

Nine women have so far had the procedure to remove and freeze their ovarian tissue with a view to delaying the menopause when they are older. Doctors use keyhole surgery to remove a small piece of ovarian tissue, which is then sliced up and frozen to preserve it.

When the women enter the menopause, potentially decades from now, the frozen tissue can be thawed out and grafted back into the body. To restore falling hormone levels, doctors typically choose a site with a good blood supply, such as the armpit. Provided the ovarian tissue survives the process, it should restore the woman’s declining sex hormones and halt the menopause.

“This is the first project in the world to provide healthy women ovarian tissue cryopreservation purely to delay the menopause,” the company’s chief medical officer, Yousri Afifi, told the Sunday Times.

Doctors already use a similar procedure to protect the fertility of girls and women who are about to have cancer treatment. Before they begin anti-cancer therapy, doctors remove some ovarian tissue and freeze it. If the woman wishes to have children in the future, the tissue is then thawed out and reimplanted next to the fallopian tubes, which pick up the mature eggs that are released by the tissue.

How much the new procedure will delay the menopause depends on the age when the tissue is taken and when it is put back. Tissue taken from a 25-year-old might postpone the menopause for 20 years, while that taken from a 40-year-old might only delay its onset for five years.

Fishel points out that young women today can expect to spend 30 to 40 years in the menopausal stage and while many will benefit from hormone replacement therapy, it does not suit everyone.

Richard Anderson, the deputy director of the Centre for Reproductive Health at Edinburgh University, has performed ovarian tissue freezing for young girls and women for 25 years. He said it was “old news” that the transplants could restore hormone levels, but added: “What is less clear is whether this is a safe and effective way of doing so.”

Beyond postponing menopause, the doctors believe the procedure could save the NHS substantial amounts of money by reducing treatment costs for the menopause and more serious, related problems such as heart conditions and osteoporosis.

But it could also be a game-changer for fertility treatment. Unlike IVF, ovarian tissue preservation does not require drugs to stimulate the ovaries, and is likely to produce far more eggs. If women in their 20s routinely had ovarian tissue removed and stored, Fishel said, they could potentially have access to thousands of eggs should they later decide to have children.

Women could even have part of their tissue reimplanted to restore their fertility before starting a family, and the rest regrafted later to hold off the menopause, he said.