August 5, 2019

expert reaction to Sunday Times exclusive on new therapy attempting to delay the menopause by preserving functioning ovarian tissue

A company called ProFaM (Protecting Fertility and Menopause) reports to have developed a therapy to allow women to delay the onset of the menopause though the preservation of functioning ovarian tissue. 

Dr Melanie Davies, Chair of Fertility Preservation UK, said:

“Women experiencing menopause should take professional unbiased advice.​

“Ovarian tissue freezing has a role for preserving fertility in patients undergoing chemotherapy or radiotherapy where there is insufficient time, or they are too young, for ovarian stimulation for egg/embryo freezing.  But ovarian tissue is NOT a ‘preferred method’ of fertility preservation, and it has no proven benefit for healthy women in “delaying the menopause”.

“Physiological HRT is highly effective, simple and very safe for most women.  In contrast this new approach involves undergoing at least two operations, to remove and regraft ovarian tissue, with no guarantee of long-term benefit.  There is no evidence to support the claims made here about preventing osteoporosis and cardiovascular disease let alone depression and sexual problems.

“Moreover, HRT is very inexpensive compared to having laparoscopic surgery in the private sector and the cost of years of cryostorage.

“The NHS does not pay for unproven therapies so it should not be offering this therapy.”

Prof Richard Anderson, Elsie Inglis Professor of Clinical Reproductive Sciences and Head of Section of Obstetrics and Gynaecology, MRC Centre of Reproductive Health, University of Edinburgh, said:

“Ovarian cryopreservation for later replacement has been carried out for many years around the world, generally for young women facing loss of ovarian function as a result of cancer treatment.  The focus has been on restoration of fertility, as eggs aren’t as replaceable as hormones.  There are now several hundred women worldwide who have had ovarian tissue replaced, with almost all showing hormonal activity.

“So it is ‘old news’ that ovarian transplants can provide hormone replacement, but what is less clear is whether this is a safe and effective way of doing so.  One only has to remember the epidemic of endometrial cancer following the introduction of oestrogen-only HRT that led to the recognition that progesterone was an essential component to make HRT much safer: we need similar data on ovarian transplantation before it can be considered a safe option for women.”

Declared interests

Dr Melanie Davies: “Consultant Gynaecologist, University College London Hospitals.  Chair, Subspecialty Training Committee, RCOG Chair, Fertility Preservation UK, SIG of British Fertility Society.  Chair, Post-Reproductive Health​ Clinical Studies Group, British Menopause Society.  Chair of Trustees, Elizabeth Garrett Anderson Hospital Charity.  I lead the Fertility Preservation service and also the Menopause service at University College London Hospital.  I am on the Medical Advisory Council of the British Menopause Society and I am also on the Executive Committee of the British Fertility Society.  I do a small amount of private practice, in which I give the same advice to my patients as I have given in the opinions above.”

Prof Richard Anderson: “Prof Anderson has been performing ovarian tissue freezing for replacement for 25 years for girls and young women.”