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Infertile patients cannot afford to wait for treatment while their eggs get older.

Dr. Sherman Silber, Infertility Center of St. Louis, is offering video consultations for patients who need to plan now for their treatment while stay-at-home orders are in place. He is talking to and evaluating patients in their home to comply with social distancing measures.

Dr. Silber is discovering that patients actually prefer this method of telemedicine consultation over the conventional office visit. Patients have conveyed that “it is so much more convenient and less stressful” to have a telemedicine personal consultation than to take a day off from work to travel to the doctor’s office and sit with other nervous patients in the waiting room.

The COVID-19 pandemic is thus changing much of the way we will do things in the future, and for the better. “Our patients are surprisingly much happier with this approach. Of course, at some point we need to perform hands on treatment. But with this new manner of seeing patients, we can come to the right diagnosis and treatment plan for most patients more efficiently, quickly, and painlessly, with no loss of personal one-on-one communication.” This is a very welcome new era of telemedicine that has been forced on us by the current difficult times.

Revolutionary Ovary Allotransplantation Pregnancy

A Hopeful Breakthrough for Turner’s Syndrome Patients 

ST. LOUIS MISSOURI, October 2, 2023 

In a groundbreaking medical milestone, a team of researchers has successfully performed the world’s first ovary tissue allotransplantation to a Turner’s syndrome patient resulting in a successful pregnancy, offering hope to thousands of women who have long faced fertility challenges due to this genetic condition. This pioneering procedure, using an innovative and safe immunosuppression protocol, opens new possibilities for natural pregnancy in Turner’s syndrome patients, without the need for donor egg in vitro fertilization (IVF). Dr. Mats Brännström at The University of Gothenburg, Sweden, who performed the world’s first uterine transplant, said, “This ovary allotransplant is a major breakthrough in reproductive medicine”. Dr. Claus Andersen at the University of Copenhagen, Denmark said, “This indeed shows that experience from uterus transplantation can be applied to ovary as well”. 

The Turner’s Syndrome Challenge 

Turner’s syndrome is a rare genetic disorder that affects approximately one in 2,500 females. Women with Turner’s syndrome typically experience severe infertility, completely running out of eggs in early childhood. While donor egg IVF has been a solution for some, there is no return of hormonal function, and religious and personal feelings have posed significant barriers to using donor eggs.  

A Breakthrough Approach 

This groundbreaking research, led by Dr. Sherman Silber at the Infertility Center of St. Louis took a unique approach to address the fertility challenges faced by Turner’s syndrome patients. The team successfully transplanted ovary tissue from a non-identical donor to a 20-year-old Turner’s syndrome patient. Her 22-year-old sister, who was HLA identical but ABO incompatible, served as the generous donor. 

The Procedure 

The procedure involved removing and dissecting a portion of the donor’s left ovary. One third of the cortical tissue was transplanted to the recipient’s right streak ovary, while the remaining two-thirds were cryopreserved for future use. What makes this achievement even more remarkable is the use of an innovative and safe immunosuppression protocol, similar to that employed in uterine transplantation. The immunosuppression protocol was carefully curated by Dr. Daniel Brennan (Johns Hopkins Medical School) and Dr. Rowena D. Santos (Washington University School of Medicine).  

Promising Outcomes 

The results have been nothing short of extraordinary. By 168 days post-surgery, the Turner’s syndrome recipient had resumed normal menstruation, and her FSH levels had come down to normal. Her AMH levels began to rise, indicating successful normal ovary function. The Turner’s syndrome recipient continued to menstruate monthly and became spontaneously normally pregnant 1.5 years later, with no IVF and no donor eggs. 

A Ray of Hope 

This medical breakthrough not only offers new hope to Turner’s syndrome patients but also addresses critical issues related to hormonal function. Patients may no longer require hormone replacement therapy (HRT), and pregnancy can occur naturally, alleviating the need for donor egg IVF. Furthermore, this case has established that ovary cortical tissue grafts can survive solely on diffusion, eliminating the need for revascularization. 

Dr. Sherman Silber, the lead investigator, notes, “Young women with Turner’s syndrome have long yearned for the opportunity to conceive naturally and experience normal hormonal function. Our success in ovarian tissue allotransplantation, combined with safe immunosuppression, brings us one step closer to fulfilling their dreams.” This remarkable achievement challenges conventional fertility treatments, offering hope to Turner’s syndrome patients who desire natural pregnancies while preserving their cultural and personal beliefs. 

About Dr. Sherman Silber: 

Dr. Sherman Silber, a renowned pioneer in microsurgery and infertility, is considered one of the world’s leading authorities in the field of infertility. This includes IVF, Mini-IVF, sperm retrieval, ICSI, vasectomy reversal, male infertility, tubal ligation reversal, egg and embryo freezing, ovary transplantation and the reproductive biological clock. For over 43 years, Dr. Silber has originally developed all of the most popular fertility treatments used around the world today. Dr. Sherman J. Silber was recognized as one of the “Giants in Reproductive Medicine” at the 6th IVF Worldwide Online Congress. The honor recognized his contributions to the field of infertility and transformation of patient care through his career, research pursuits, and mentorship of others. Silber is the medical director at the Infertility Center of St. Louis.  

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