Yale fertility scientist claims he has worked out how to delay the menopause INDEFINITELY - in breakthrough th
By Nikki Main Science Reporter For Dailymail.Com
Published: 15:56 GMT, 23 January 2024 | Updated: 16:21 GMT, 24 January 2024
A procedure used to treat infertility in cancer patients may now be the answer to delaying menopause indefinitely, according to a new study.
Mathematicians discovered that by implanting a woman’s previously harvested ovarian tissue, they could rebuild the follicles needed to restore their fertility.
The process is called ovarian tissue cryopreservation and has been used on cancer patients who would have otherwise become infertile from early-onset menopause brought about by their cancer treatments.
But by harvesting and freezing ovarian tissue, menopause could be delayed or even eliminated if the tissue was returned in fractions, with multiple tissue replacements, right before menopause occurred.
The procedure has not been studied in humans, but if the breakthrough is successful, it could mean women are fertile into their 70s and beyond.
Menopause causes mood swings, aches and pains, hot flashes , painful migraine, and weight gain, among other symptoms.
“For the first time in medical history, we have the ability to potentially delay or eliminate menopause,” said Kutluk Oktay, MD, PhD, who led the study.
Oktay is afertility specialist and ovarian biologist who is director of the Laboratory of Molecular Reproduction and Fertility Preservation and adjunct professor of obstetrics, gynecology & reproductive sciences at Yale School of Medicine (YSM).
He is also the medical director and founder of the Innovation Institute for Fertility Preservation in New York and Connecticut.
The cryopreservation process is not to be confused with a woman freezing her eggs, which allows her to get pregnant later in life but before menopause.
When removed, the ovarian tissue is stored in frozen and stored in sealed containers and is kept in an environment with temperatures as low as negative 320 degrees.
The tissue is then thawed, typically years in the future, and reimplanted under the patient’s skin and within 10 days it reconnects to the surrounding blood vessels to restore the ovarian function.
The entire process takes about three months, according to the YSM.
Oktay compared the process to a parent's decision to freeze their baby's cord blood when they're born in case they need it later in life for any health issues.
Freezing ovarian tissue works in the same way, he said, and could also be extracted while undergoing a separate procedure such as endometriosis.
The tissue will stay alive for 24 hours, allowing the gynecologist to send it to a lab to be frozen.
About 11 percent of healthy women experience menopause late, which is after 55 years old, and for some women, they could experience health complications like heart failure, cardiovascular disease, stroke, type 2 diabetes, and many other symptoms.
Because of this, Oktay said women who have a family history of menopause-related complications 'may consider this procedure at an early age to at least bring menopause age to normal.'
He told Dailymail.com that although menopause is a natural process and many women may welcome it, he and his team originally set out with the intent to 'level the playing field' for women who are at risk for extreme symptoms or go through menopause early.
'There are even studies showing that women who have late menopause live longer,' he said, adding: 'but this could be related to common genetic origins such as having better ability to repair DNA.'
Oktay developed cryopreservation in the 1990s and performed the first ovarian transplant procedure on a cancer patient in 1999.
In recent years, he focused his efforts on applying the same process to treat pre-menopausal women and created a mathematical model predicting how long the procedure could delay menopause.
The model shows how long menopause would be delayed, depending on how old the woman was when the ovarian tissue was harvested.
It showed that the younger a woman was when she underwent cryopreservation, the longer her menopause would be delayed.
For example, a woman who preserved her ovarian tissue at 25 years old would delay menopause by an average of 15.6 years while a woman who harvested her tissue at age 40 would only delay it by an average of 3.4 years.
The model shows how long menopause would be delayed, depending on how old the woman was when the ovarian tissue was harvested. The top line represents the maximum number of years menopause can be delayed for 25-year-old women, while the bottom represents the shortest amount. The middle number is the average number of years menopause could be delayed if tissue is harvested at 25 years old.
The results are based on the assumption that a woman would only have a single replacement, but if they instead opted to replace fractions of their tissue over several years, they could possibly prevent menopause from ever occurring.
‘If ovarian tissue can be frozen under the age of 30 years, in theory, menopause can even be eliminated in some cases,’ the study said.
‘However, the feasibility and safety of delaying menopause beyond age 60 need to be clinically evaluated.’
Researchers used existing biological data about the rate at which women’s follicles decrease and built a model of how many dormant eggs, called primordial follicles, are still present in a woman’s ovaries at the time of menopause.
They developed the model to reflect how ovaries age based on how many follicles are inside the ovaries.
“The younger the person, the larger the number of eggs she has, as well as the higher the quality of those eggs,” Oktay told YSM.
‘The model accounts for women between the ages of 21 and 40. Beyond age 40, data show that the procedure is unlikely to delay menopause for a woman with an average egg reserve, but this can change with the development of more efficient freezing and transplantation methods in the future,’ he said.
Researchers said it is important to consider the health benefits associated with putting off menopause which causes mood swings, aches and pains, hot flashes, painful migraine, and weight gain, among other symptoms.
‘A lot of the interest behind delaying menopause is fertility, but a lot of it also comes from the idea that functioning ovaries are better for a woman's health," Sean Lawley, a co-author of the study and associate professor at the University of Utah, said.
‘Menopause is associated with many health issues relating to cardiovascular disease, bone density, obesity, etc.
‘Keeping ovaries functioning longer might delay or even prevent these health issues from starting,’ he added.
Joshua Johnson, an ovarian biologist at the at the Colorado University Anschutz Medical Campus and John Emerson, professor of Statistics and Data Science at Yale University were also involved in the study.