Sarah-Kate Templeton, Health Correspondent
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Doctors have managed to extract eggs from five-year-old girls and freeze them for use when they are old enough to have children.
The scientific advance, which had been thought impossible, will enable girls suffering childhood cancers such as leukaemia to become parents in later life. Thousands are left infertile each year after undergoing chemotherapy.
It also opens the possibility of storing girls’ eggs to protect them against any form of infertility in later life.
Previously it was believed the eggs of prepubescent girls were too immature to be extracted. It was thought they became viable only at puberty by reacting to hormonal changes in the body.
Israeli doctors have, however, managed to extract the eggs and then culture them in test-tubes to make them viable. The resulting eggs are no different to those of a 20-year-old, say the doctors.
The doctors are part of the same research team that made medical history by treating a mother who gave birth to twins from embryos frozen 12 years earlier. The experiment demonstrated that eggs or embryos could be frozen for lengthy periods without damage.
Dr Ariel Revel, a lecturer in obstetrics and gynaecology at Hadassah University hospital, Jerusalem said: “We have developed a technique which allows us to obtain eggs even from girls and to mature them in vitro. We isolate eggs from the tissue and, following one or two days in culture, they are mature enough for freezing.
“The results are quite surprising. Since these girls are not menstruating, we would expect maturing them to be very difficult, but we have shown that they do mature. The cancer treatment these girls are having will almost certainly cause them to become infertile. Although this is still experimental, any technique that tries to restore fertility to these girls is worth trying.”
Revel will present the full results of his research at the annual meeting of the European Society of Human Reproduction and Embryology in Lyon, France, this week.
About 1,500 children undergo treatment for cancer every year in Britain. Seventy-five per cent survive the disease but many will be left infertile by radiotherapy and chemotherapy treatment.
The breakthrough has been welcomed by British cancer and fertility doctors. Professor Gedis Grudzinskas, medical director of the Bridge Fertility Centre, London, said: “This is very important because this is the first time that human eggs have undergone changes in the test-tube which normally take place during puberty.
“Prior to puberty the ovaries are not sensitive to hormones. They become sensitive to hormones gradually during puberty. This is a subtle change and it is amazing that this can occur in a Petri dish.”
But Josephine Quintavalle of Comment on Reproductive Ethics, a campaign group worried about some forms of in vitro fertilisation techniques, expressed concern that if the eggs were donated to a woman of childbearing age, a resulting child could have a biological mother who was only a few years older.
Quintavalle said: “Are we going to end up with a child who has a mother who is just six years older? What happens if the child dies? Could the eggs be donated to someone else?
“I don’t think this is the first priority for five year olds. Any intervention for a child going through cancer treatment is an added burden. I feel uncomfortable about this development.”
Doctors have previously frozen the ovarian tissue of several young girls and plan to transplant pieces of the organs back into their bodies when they are older.
So far, however, there have been only two reported pregnancies after ovarian tissue of adults has been frozen and transplanted. The outcome for girls is unknown.
Ovarian tissue could also contain cancerous cells. This risk would be eliminated by freezing and implanting eggs. Across the world more than 100 children have been born from frozen eggs.
Dr Hamish Wallace, a consultant paediatric oncologist at the Royal Hospital for Sick Children in Edinburgh, said: “Maturing in vitro a primitive egg from a five-year-old girl would be a huge advance.
“Doctors wouldn’t need to worry about the ovarian tissue being contaminated with some of the original cancer cells and reintroducing the cancer into the body.”
Israeli scientists have also suggested taking eggs from aborted foetuses. Doctors at the Meir Hospital in Kfar Saba said aborted foetuses could one day become the “mother” of a new baby by donating eggs to an infertile woman.
A woman has her greatest number of eggs, about 5m, as a five-month-old foetus. By the time she is born, about 4m will have disintegrated. By the timea girl reaches puberty, only 300,000 will remain.
From then on, a woman will ovulate one egg each month and have few eggs left by her mid-forties. She will have ovulated about 500 and the remainder will have disintegrated.
The first reported birth from a frozen egg was in 1986. The practice began for medical reasons but is now being used for social purposes.
British women in their thirties who have not yet met their partner or who wish to postpone childbirth to concentrate on their career, are increasingly freezing their eggs. Although scientists initially feared the structure of the eggs would be damaged by the process, many now believe the procedure to be safe and effective.
Eggs are currently frozen using a process known as cryo-preservation, where they are placed in a storage tank containing liquid nitrogen. Scientists have recently developed a more advanced freezing technique, called vitrification, which causes less damage to the eggs.
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My daughter at 18 months old went through chemo treatment due to a cancer called Neuroblastoma. Which by the way... is NOT hereditary. Just because she has a child of her own does not mean her child will get cancer. This new science is a blessing to those who might never have had the opportunity to have kids of their own because of chemotherapy treatment. These young children did not choose to have cancer.
Michelle, Phoenix, AZ
So let's boycott Israeli research, why not?
Ora, Rehovot, Israel
I can't believe they could so casually suggest that an aborted fetus could be the source of eggs. If she can be the mother of someones child, she probably shouldn't have been aborted in the first place.... I guess she doesn't get a "choice", though.
rachel, olsburg, kansas
I agree with Lynn, I would also be concerned about passing on cancer to my child. Another thought to consider is this... There are many, many, many children of all ages in this world who desparately need a family. Has it ever occurred to anyone that maybe some women who are unable to have a biological child might be inclined to adopt one or two of these adorable children and make them their very own child. It would seem that we would have less children in this world who are starving, lacking a loving, nurturing, structured family who could provide permanence in their lives if only science wasn't so eager to discover new ways to grow life in a petri dishes and test tubes.
Kimberly, Wilmington, NC/USA
As a woman who went through early menopause and worries my two girls may do also before they have a chance to have kids, this is a godsend. I can now monitor their reproductive early years and if it looks like they may go through menopause early this will now be available!!! I no longer feel i have passed on a terrible curse.
nicole, sydney, australia
Worried about the demographic timebomb...ehh?
Trust me, nothing will help
richard, Los Angeles, USA
I have a friend who received extensive chemotherapy when she was 12. Of course, she is now sterile, but wishes she could have kids. This is a great advancement for these kids that have undergone chemo or radiation at an early age. I also have to ask myself though, "At what point to we stop playing God?"
Cynthia, Raleigh, MS
Beautiful...thank you scientists!
Los, Boca Raton, Florida, US
Lynn - not all cancers have strong genetic components (though I admit that cancers in children are more likely to be genetic), and with rapid advances in genetic screening, there is the possibility of testing for eggs unaffected by the particular condition. You bring up an important issue, but much depends on the situation, and I think the larger point here is a breakthrough that will allow a woman to even have a chance to make that decision when the time comes.
M, St. Paul, MN
Fertility treatment causes a lot of suffering. The success rate is just 20% . Marriages break down from the stress and may become financially ruined because of the price of treatment. It is a business built on the dreams and hopes of women who want to have a child.
The problem is that women generally don`t desire to donate eggs ( a painful and sometimes dangerous procedure). So the industry has come accross a set-back; a lack of eggs. There is the possibility of offering money for eggs, but still, it is unlikely that many women could be bribed (besides the ethical argument of the trafficking of human body parts). I had thought that this would mean the industry would have to stop exploiting childless women sooner or later.
Never in my wildest nightmares did I imagine that humans would stoop so low as to take eggs from aborted foetuses in order to fuel this money making machine.
5 year old girls also have the right not to be harvested for eggs by greedy doctors.
Sakura, Wrexham, UK
In most cancers that are caused in young girls, are not usually hereditary. My mother, who had leukaemia at fourteen has not passed the disease to me. She had children younger, as there was great fear she could have kids. This process is GREAT. I'm so glad that this process is now available.
Kathryne, Austin, Texas
why would anyone that has had cancer want to take the chance of passing it on to an offspring?? this puzzles me.
Lynn, Fayetteville,