Surgery for menopause - an irresponsible message?

The controversial menopause treatment ovarian tissue cyropreservation has hit the headlines again.

The experimental technique was highlighted in a recent article in The Mail where Zoe Ball spoke out about the difficulties of hitting the menopause. There is no suggestion that Zoe Ball is promoting this treatment. 

Ovarian tissue cyropreservation, also known as ovarian grafting, uses healthy tissue from a woman's ovaries to delay the onset of the menopause; the idea being that the tissue can be reinserted at a later date.
 The British Menopause Society’s medical advisory committee has previously stated that cyropreservation requires, “further assessment and evaluation” has been suggested as a potential treatment to delay menopause in a recent article in The Daily Mail. 

Specialist gynaecologist Mike Savvas from The London PMS and Menopause Clinic, has cast doubt upon claims in The Mail that cryopreservation is a useful treatment for delaying the menopause. He says, "It is difficult to imagine" that this procedure could work“
. Mr Savvas explained; "Ovarian tissue freezing is not new. It has been done for many years, to preserve fertility for women with cancer who are about to undergo chemotherapy or surgery that will render them sterile. The procedure seems effective and useful as a way of preserving eggs. The frozen ovarian tissue can then be grafted back after completion of cancer treatment, when the woman wishes to have a baby. The procedure has been shown to be useful, in that the ovarian tissue can produce eggs for some time, to enable a woman to get pregnant, usually with IVF, or sometimes naturally."

However, he warned: "However, we do not know how long the grafted ovarian tissue will continue to produce sufficient hormones to prevent the symptoms and long term consequences of the oestrogen deficiency of the menopause. There is no long-term data, and it is wrong to claim that it will delay the menopause by 20 years. It is difficult to imagine that transplanting such a small volume of ovarian tissue will produce adequate levels of oestrogen for very long. Furthermore the excision of ovarian tissue is not without risks as it involves a surgical procedure and removing a piece of the ovary may itself hasten the menopause". 

Mr Savvas goes on to say, "It is one thing to transplant ovarian tissue which will function for a short while to enable a woman to get pregnant and quite a quite another matter to transplant ovarian tissue that will continue to produce hormones for many years. This is an expensive procedure and carries risks. Hormone replacement therapy remains the only proven and safe and effective method of controlling the symptoms of the menopause and preventing the long term effects of oestrogen deficiency of the menopause.

The technique, which received widespread publicity earlier this year, was met with wariness by doctors.

Hormone replacement therapy remains the only proven and safe and effective method of controlling the symptoms of the menopause. This view seems to be shared with other senior consultant gynaecologists;

In a comment piece, Ovarian tissue grafts to combat the menopause for Bionews , Ms Melanie Davies, consultant gynaecologist at University College London Hospitals says, "Although the chance of ovarian tissue being successfully replaced is good, its function is limited because at least half of the stored eggs are lost during the process of freezing, thawing and regrafting. There are very few reports of grafts functioning beyond 10 years and none for 20 because the technique has not been around long enough. In fact, evidence shows that many grafts fail after one-two years".

Drastic approach with uncertain benefit

She continues saying, "To remove and regraft the tissue requires at least two operations, and probably more as ... small amounts of tissue will be replaced at intervals to prolong the effects". Miss Davies also points out that, "Surgery is also not without risk". She goes onto explain that The Royal College of Gynaecologists advises: 'The overall risk of serious complications from diagnostic laparoscopy is approximately two in 1,000 women. This includes damage to the bowel, bladder, ureters, uterus or major blood vessels which would require immediate repair'. Risks are even higher from operative laparoscopy. Ms Davies says, "Surgery for uncertain benefit seems a drastic approach to the menopause, when good alternatives are available".

Consultant gynaecologist, Mr Neale Watson said that to suggest ovarian tissue grafts were a viable treatment for women wishing to delay the menopause was “totally irresponsible”. He added: “The only studies are with cancer patients where a large portion of the ovary can be removed. If this is removed in the premenopausal women it will reduce their fertility and potentially bring on an early menopause."

The organ that stores urine. Full medical glossary
A fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. Full medical glossary
A common name for the large and/or small intestines. Full medical glossary
Abnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. Full medical glossary
The use of chemical substances to treat disease, particularly cancer. Full medical glossary
A condition that is linked to, or is a consequence of, another disease or procedure. Full medical glossary
The removal of a piece of tissue or an organ from the body. Full medical glossary
A substance produced by a gland in one part of the body and carried by the blood to the organs or tissues where it has an effect. Full medical glossary
In vitro fertilisation. Fertilisation of the female reproductive cell (ovum) outside the body, before implantation into the uterus (womb). Full medical glossary
Keyhole surgery that uses an instrument called a laparoscope to examine the abdominal or pelvic organs. Full medical glossary
Relating to the menopause, the time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle. Full medical glossary

The time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle, and her periods cease

Full medical glossary
multiple sclerosis Full medical glossary
A hormone involved in female sexual development, produced by the ovaries. Full medical glossary
relating to the ovaries Full medical glossary
Female reproductive organs situated one on either side of the uterus (womb). They produce egg cells (ova) and hormones in a monthly cycle. Full medical glossary
A group of cells with a similar structure and a specialised function. Full medical glossary
A tube that carries urine from the kidneys to the bladder. Full medical glossary
Two tubes that carry urine from the kidneys to the bladder, where it is stored. Full medical glossary
The womb, where embryo implantation occurs and the growing foetus is nourished. Full medical glossary
Capable of survival. Full medical glossary