Family Matters

Want to Freeze Your Biological Clock? One Doc Says, Go for It

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After 10 years of marriage ended in divorce and no children, Julie Lorber knew she had to take extreme measures if she ever hoped to become a mother. Two years ago this week, Lorber, now 39, elected to remove a chunk of her right ovary. She froze both the tissue and, by default, her biological clock, joining a trickle of highly educated professional women who are choosing to skirt biological limitations in pursuit of a someday family.

For Lorber, from O’Fallon, Ill., egg preservation wasn’t realistic because it can involve multiple hormonal stimulation cycles, and she was in the middle of a rigorous surgical residency. Nor did she have a partner with whom to freeze embryos. But fast-forward, and now she’s got a boyfriend, a plan to get married and designs on a baby. After the first of the year, she plans to have her frozen tissue thawed and transplanted. “I think there should be no controversy,” says Lorber, now a general surgeon who laughingly tells her boyfriend that “the babies are over there” when they pass by the St. Louis hospital where her tissue is cryopreserved. “Our society is so focused on career, and that’s what I focused on because I had to. I’m thankful I had an option to do what I did because now children are a priority in my life.” (More on 5 Pregnancy Taboos Explained (or Debunked))

At last week’s meeting of the American Society for Reproductive Medicine, Sherman Silber, the flamboyant fertility specialist who performed Lorber’s surgery and serves as director of the Infertility Center of St. Louis at St. Luke’s Hospital, set tongues wagging when he told colleagues that banking ovarian tissue from otherwise healthy young women who are simply not ready to have children yet should be widespread. It’s the equivalent of stopping the tick-tock of maternal hormones: a 25-year-old woman who stores tissue has a veritable motherlode of thousands of 25-year-old eggs ready to be transplanted down the road when she might be infertile due to age. Whether that’s in 10 or 20 years is up to her. Biology be damned.

In the past decade or so, Silber – like an increasing number of fertility doctors — has frozen ovarian tissue from about 60 women diagnosed with cancer in case treatment might leave them infertile. He successfully reintroduced tissue into Amy Tucker, the first U.S. cancer patient to give birth via ovarian transplant; her son was born in May. Worldwide, the technique has yielded more than 20 babies. Apparently the only doctor in the U.S. to sanction fertility preservation in healthy women, Silber has frozen tissue or eggs from nearly 80 would-be mothers who seek to extend their child-bearing years. Removing ovarian tissue, done laparoscopically, he says, is a “very robust and easily transferable procedure.” Silber’s success with Tucker — underscored by a thumbs-up from Hillary Clinton — has given him the confidence to try to convert his profession. (More on Photos: Pregnant Belly Art)

What’s Hillary got to do with it? Two years ago, shortly before the election, Silber attended an intimate breakfast with Hillary Clinton for top Obama fundraisers. She asked what the eight attendees did for a living. He likes to recount how he told her of his work and explained infertility is on the rise as women increasingly delay child-bearing until their 30s and 40s.

“We can freeze ovaries or eggs for cancer patients,” he told her, “but there’s a lot of ethical debate in our society about whether we should do this in general.” (More on The New World of Oncofertility)

As Silber recalls, Clinton interrupted him: “Look, this is a no-brainer.”

These days, it seems like they might be some of the only ones who feel that way — or admit they do. There haven’t been nearly enough procedures performed or babies born to legitimately endorse the technique, says Art Caplan, director of the Center for Bioethics at the University of Pennsylvania. “It’s not ready for prime time,” says Caplan. “He’s not wrong that someday women may want to consider some kind of biological insurance, but right now it’s extremely experimental.”

Although scientific progress is being made, even experts such as Teresa Woodruff — a vocal advocate of ovarian tissue cryopreservation as director of the nationwide Oncofertility Consortium, which aims to combine fertility preservation with cancer diagnosis — aren’t comfortable recommending the technique to healthy women. The procedure is still considered investigational enough that Woodruff’s own lab at Northwestern is researching how and why it works. (More on Video: Filming Embryos Improves Chances of Pregnancy)

In any case, why bother? There are already two other options out there — freezing eggs or embryos — that can also result in a baby. “There are better ways to do this,” says Woodruff.

Banking ovarian tissue indefinitely has other pitfalls, too, namely more difficult pregnancies as women age. “The ovary is set up to produce the best eggs during the time they are most likely to produce a healthy outcome, and that healthy outcome is for both mom and baby,” says Woodruff.

So far, just a handful of women have heeded the pitch on Silber’s website that “a woman now has the option to breathe more easily, and not feel rushed into marriage or pregnancy before she is ready!” Among them is a 38-year-old woman who froze tissue in order to help her space out her children three years apart. (She got pregnant with her first naturally but anticipates needing assistance by the time she attempts to conceive baby No. 3 at age 44 or so.)

Eventually, Silber believes that freezing ovaries for social reasons will become as acceptable as the once-controversial in vitro fertilization (IVF) techniques are today. Years ago, IVF was both ridiculed and riddled with controversy. Now it’s standard fertility treatment fare. Could tinkering with a woman’s biological clock share that same destiny? (More on Building a Brighter Kid: Consider IVF)

Silber is hopeful, yet realistic. “It is considered a little unusual,” he says.

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