Menopauses effects vary among ladies, with some valuing liberty from menstruation and pregnancy worries and others fighting with signs like hot flashes. New research study focus explores postponing menopause to extend fertility and minimize health threats, with groundbreaking work at Yale using ovarian tissue freezing to possibly eliminate or postpone menopause, raising arguments on the naturalness and medicalization of this life stage.Most ladies agree that menopause has its drawbacks and advantages. While some value completion of menstruations and issues about unexpected pregnancies, others fear the potential for hot flashes, mood swings, and other unwelcome signs. What some females think about a quick and barely visible stage in their lives can evolve into long lasting changes and discomfort for others.Now, a new paradigm around the biological processes of menopause is catching the attention of a little group of researchers around the country. The primary question: can menopause be delayed in healthy females, permitting them to extend their child-bearing years– and maybe even forestall a few of the health risks and uneasy symptoms connected to dropping estrogen levels? These concerns can be questionable: Some individuals think that such research might cause life-changing benefits for ladies, while others think about menopause to be a biologically driven life phase that must not be pathologized by medical science.At Yale School of Medicine (YSM), Kutluk Oktay, MD, Ph.D., an ovarian biologist who is director of the Laboratory of Molecular Reproduction and Fertility Preservation, recently added a brand-new chapter to this discussion by publishing research on various possible outcomes when menopause is postponed in healthy ladies through ovarian tissue freezing.Oktay, who developed and performed the worlds first ovarian transplant procedure with cryopreserved tissue for a client with a medical sign in 1999, sees a future in which healthy women might use this process of freezing tens of countless eggs within the ovarian tissue to stave off menopause for as long as several decades– or perhaps prevent its onset completely.” For the first time in medical history, we have the capability to potentially remove or postpone menopause,” said Oktay, who is likewise an adjunct professor of obstetrics, gynecology & & reproductive sciences at YSM.A mathematical model predicts results for postponed menopauseUsing data from hundreds of previous ovarian cryopreservation and transplantation procedures, and molecular research studies of how ovarian roots behave in ovarian tissue, Oktay and his coworkers built a brand-new mathematical model, published in the American Journal of Obstetrics & & Gynecology, to forecast the length of time the surgical treatment might possibly postpone menopause under a series of scenarios in healthy women.Since Oktay performed the first successful transplant with cryopreserved tissue, ovarian tissue cryopreservation has actually been effectively utilized in cancer clients to preserve their fertility before their treatments, which can often completely harm the egg reserve in the ovaries and trigger menopause. Throughout this outpatient treatment, a surgeon laparoscopically removes the entire ovary or layers of the external part, which includes hundreds of countless dormant, immature eggs (known as primordial hair follicles). These tissues are then kept in sealed containers after being frozen with a specialized process and kept as low as negative 320 degrees Fahrenheit. Freezing ovarian tissue with this specialized process protects it for later usage. Eventually– normally years– in the future, the surgeon reimplants the thawed tissue into the client either laparoscopically or with an easy procedure, using methods developed by Oktay, that puts the tissue under the patients skin while intravenous sedation is administered. Within three to 10 days after that, this transplanted tissue restores connections with the surrounding capillary and restores ovarian function in about 3 months.The just recently released mathematical model focusing on healthy females undergoing ovarian tissue cryopreservation considers several factors, including the age at which a patient gets the treatment, which plays a substantial function in how long menopause can potentially be delayed.” The younger the individual, the bigger number of eggs she has, as well as the greater the quality of those eggs,” Oktay said. The model accounts for females in between the ages of 21 and 40. Beyond age 40, information reveal that the treatment is unlikely to postpone menopause for a female with typical egg reserve, however this can alter with the development of more efficient freezing and transplantation methods in the future.Furthermore, the model uses insight into the perfect amount of ovarian tissue to collect. The more tissue a cosmetic surgeon eliminates, the longer the procedure can possibly delay menopause. Nevertheless, the removal of excessive tissue can lead to early menopause. “This design offers us the optimal amount of tissue to harvest for a person of a given age,” stated Oktay.The model likewise considers the healing process after a cosmetic surgeon returns the gathered ovarian tissue to the patient. Throughout this healing procedure, a few of the prehistoric roots are lost. Studies on animal designs reveal that as many as 60% of primordial roots do not endure post-transplantation, leaving 40% that are practical. With newer technologies, Oktay stated that he thinks surgeons can obtain a survival rate of approximately 80%. As the procedure continues to improve, he wishes to ultimately achieve a 100% survival rate. Hence, the design represent survival rates varying from 40% to 100%. Furthermore, through transplanting portions of the harvested tissues over a number of procedures, the research study suggests that menopause can be delayed even longer. The groups model shows that returning a third of the outer portion of the ovary over each of 3 treatments postponed menopause longer than returning all of the tissue through one surgery.Based on the design, Oktay forecasts that for a lot of females under 40, ovarian cryopreservation can considerably delay menopause. And for women under 30, the procedure may have the ability to avoid menopause altogether.Because numerous women lose their capability to conceive earlier than they prefer, ovarian cryopreservation might be an appealing choice for them, said Hugh S. Taylor, MD, chair and Anita OKeeffe Young Professor of Obstetrics, Gynecology & & Reproductive Sciences at YSM. “Women are also regularly postponing pregnancy up until later on in life for expert or social factors,” he included. “The ability to freeze and later transplant ovarian tissue … provides a method to extend their fertile lifespan.” Does postponing menopause via cryopreservation deal health benefits?Delaying menopause with ovarian cryopreservation also might confer specific health advantages associated with a later menopausal age. Based on new research study by Oktay and his associates, around 11% of women experience late-onset natural menopause– or menopause after age 55. Research studies show that ladies who experience menopause later might live longer and have a lower risk for a variety of conditions, including heart disease, dementia, retinal illness, depression, and bone loss. Nevertheless, uncertainty stays over whether later menopause actually lowers those health risks. Oktay hypothesizes that those risks also might be mitigated in healthy women who postpone menopause through ovarian tissue cryopreservation.If risk for such chronic diseases is lowered in healthy women who undergo this procedure, it might be a substantial advantage. Nevertheless, Taylor said that “additional research is needed to figure out long-lasting advantages along with threats.” In continuous research, Oktay and his group are studying the outcomes of healthy women who have chosen to delay menopause through this treatment. Publication of these research studies is far in the future, however in the meantime, the mathematical design offers a beginning point for considering the feasibility and possible advantages of averting menopause in healthy women.Reference: “Modeling hold-up of age at natural menopause with planned tissue cryopreservation and autologous transplant” by Joshua Johnson, Sean D. Lawley, John W. Emerson and Kutluk H. Oktay, 4 January 2024, American Journal of Obstetrics and Gynecology.DOI: 10.1016/ j.ajog.2023.12.037.
New research focus explores postponing menopause to extend fertility and minimize health dangers, with groundbreaking work at Yale using ovarian tissue freezing to potentially remove or hold off menopause, raising arguments on the naturalness and medicalization of this life stage.Most ladies agree that menopause has its downsides and benefits. These questions can be controversial: Some individuals believe that such research study might lead to life-altering benefits for ladies, while others consider menopause to be a biologically driven life stage that ought to not be pathologized by medical science.At Yale School of Medicine (YSM), Kutluk Oktay, MD, Ph.D., an ovarian biologist who is director of the Laboratory of Molecular Reproduction and Fertility Preservation, just recently included a new chapter to this conversation by publishing research study on numerous possible outcomes when menopause is delayed in healthy females by means of ovarian tissue freezing.Oktay, who established and carried out the worlds very first ovarian transplant treatment with cryopreserved tissue for a patient with a medical indicator in 1999, sees a future in which healthy ladies might utilize this process of freezing 10s of thousands of eggs within the ovarian tissue to stave off menopause for as long as several decades– or even prevent its start altogether.” For the first time in medical history, we have the ability to potentially remove or delay menopause,” said Oktay, who is likewise an accessory teacher of obstetrics, gynecology & & reproductive sciences at YSM.A mathematical model forecasts results for delayed menopauseUsing data from hundreds of previous ovarian cryopreservation and hair transplant procedures, and molecular studies of how ovarian roots act in ovarian tissue, Oktay and his associates built a new mathematical design, released in the American Journal of Obstetrics & & Gynecology, to forecast how long the surgery might possibly postpone menopause under a range of scenarios in healthy women.Since Oktay performed the very first successful transplantation with cryopreserved tissue, ovarian tissue cryopreservation has been successfully used in cancer clients to preserve their fertility before their treatments, which can typically permanently damage the egg reserve in the ovaries and set off menopause. The teams model reveals that returning a 3rd of the outer portion of the ovary over each of three procedures delayed menopause longer than returning all of the tissue through one surgery.Based on the model, Oktay anticipates that for a lot of females under 40, ovarian cryopreservation can significantly postpone menopause. Publication of these research studies is far in the future, but in the meantime, the mathematical design uses a beginning point for thinking about the feasibility and possible advantages of averting menopause in healthy women.Reference: “Modeling hold-up of age at natural menopause with planned tissue cryopreservation and autologous transplantation” by Joshua Johnson, Sean D. Lawley, John W. Emerson and Kutluk H. Oktay, 4 January 2024, American Journal of Obstetrics and Gynecology.DOI: 10.1016/ j.ajog.2023.12.037.