City doctors perform ovary transplant

MUMBAI: India’s first ovary transplant operation was recently performed on a 17-year-old woman in Mumbai. This is only the second time an entire ovary has been transplanted anywhere in the world.
Early in March, doctors at the Zhejiang Medical Science University in eastern China are reported to have performed a similar procedure. Previously, only sections of the organ have been transplanted—and with limited success.
The Mumbai operation was performed by a team of doctors at Kothari Hospital on the woman whose ovaries were dysfunctional because of a genetic disorder.The donor was the patient’s 26-year old cousin who already has two children.
While still early, all signs seem to indicate that the transplant in Mumbai was a success. “The patient has returned home and she has menstruated, a sign that her new ovary is functioning normally,’’ said a pleased Pravin Mhatre, one of the involved surgeons.
He said it was too early to discuss the viability of a pregnancy. “What is more important is that the ovary has started producing normal sex hormones,which the patient was earlier taking through hormone replacement therapy.’’
The procedure opens up a new option for many women who lose their ovaries due to tuberculosis, chemotherapy, premature menopause or other ailments.
The teenager patient in the Kothari Hospital case has Turner’s Syndrome, genetic disorder that affects one in every 2,000 women in India, resulting in underdeveloped ovaries.
While hailing the operation as an achievement, medical experts have expressed two concerns. The first addresses the ethical dilemmas opened by the new procedure.
Any child conceived from an egg of transplanted ovary will genetically be the donor’s. In such a scenario, whom does the child belong to —the ovary donor or the ovary carrier?
“These ethical matters have to be clarified through debate since our national laws on reproductive issues are fuzzy and leave scope for much misuse and ambiguity,’’ said Kiran Coelho, a gynaecologist with Lilavati Hospital.
However, Dr Mhatre is more sanguine. Citing the Organ Donation Act of 1994, he said that a donor clearly forfeits her rights to the ovary and its eggs, and consequently to any child that may be conceived.
“Egg donors to in-vitro fertilization clinics cannot claim rights to the children conceived from donated eggs. This situation is not too different,’’ he said.
Doctors also raise fears of the misuse of organ transplants. “The high premium on childbirth in India could mean that families will be ready to pay a very high price for new ovaries,’’ warns a gynecologist with Jaslok Hospital. The rampant trade of kidneys in the country provides a sobering precedent.
However, unlike kidneys and livers, ovaries are not vital organs essential for life. Moreover,women can avail of hormone replacement therapy and in-vitro fertilisation to counter the absence of normal ovaries. Because of these alternatives, Dr Mhatre thinks that people will not go to desperate measures of buying ovaries through illegal or unethical means.
He, nonetheless, conceded that transplant surgeons and clinics had to be very careful as to whom they accepted as donors.