Tuesday, February 13, 2007

Local Doctor Pioneers Ovary Transplants





When Dr. Sherman Silber made history in 2004 by transplanting ovarian tissue from a twin into her identical sister, he said it was a unique case that he wouldn't repeat.

He changed his mind. Six sets of twins are glad he did.

Now, the St. Louis surgeon has become the first person to transplant a whole ovary — last month in twins, and last week, in non-twin sisters.

His colleagues applaud the achievement as a technical tour de force and praise Silber's pioneering spirit.

His work is exciting because it's a first step toward preserving fertility for cancer patients.

Before Silber, no one had shown that a woman's ovary could be replaced successfully. If other doctors can replicate Silber's success, a woman facing chemotherapy and radiation could have her own ovary frozen and returned to her later.

Silber's transplants have worked well because the women involved didn't require immune-suppressing drugs to keep them from rejecting the implanted ovaries.

Most sisters who are not identical twins would require those drugs, and even Silber's supporters question whether the risk of those transplants outweighs the benefits.

Benefits of a whole ovary transplant include restoring fertility and natural hormone production, which helps prevent osteoporosis, heart disease and contributes to a woman's general health. Immune-suppressing drugs can have serious side effects, and there are other ways to treat infertility and replace
hormones.

Silber's latest patient says the transplants are "opening a door" for young women locked in early menopause.

Three years ago, Joy Lagos, 30, was diagnosed with non-Hodgkins lymphoma. Her older sister Maeapple Chaney, 31, was a perfect tissue match.

Chaney gave her younger sister her bone marrow. The donation worked. Lagos was cured of her cancer, but the treatment shut down her ovaries and plunged the young woman into menopause.

"When you lose the function of your ovaries, you lose more than your fertility," Lagos said.

She developed osteoporosis. Her sex drive waned.

"I didn't feel like a woman," she said.

TV report opens door

Chaney was willing to donate eggs so Lagos and her new husband, Rodrigo Lagos, could have a baby through in vitro fertilization. (The couple got married last September.) But Lagos wanted to feel like a young woman again. Her sister was willing to do anything she could to help. So Joy Lagos began looking for someone who would transplant her sister's ovary into her.

Rodrigo Lagos was flipping through television channels one day. A teaser featuring Silber caught his eye. He recorded the "medical miracle" program featuring Silber's first ovarian tissue transplant.

He couldn't quite believe what he saw, so he searched the Internet. The first hit was Silber's clinic at St. Luke's Hospital. The second was a New England Journal of Medicine article describing the first transplant.

The Lagoses knew then that Silber was exactly the person they were looking for.

So Lagos and Chaney headed from their homes in California to the Infertility Center of St. Louis at St. Luke's, which Silber directs.

Last week, Silber removed one of Chaney's ovaries and gave it to Lagos. Such surgery is incredibly difficult because the artery that feeds blood to the ovary is no bigger around than a thread. Other gynecological surgeons described Silber as a "brilliant" and "extremely skilled" microsurgeon.

"Not everyone is going to play golf like Tiger Woods. It's the same thing," said Dr. Richard Gimpelson, a colleague of Silber's at St. Luke's and the past president of the AAGL, an association of gynecological surgeons.

Even so, reattaching the blood supply to the ovary is the most difficult procedure Silber has ever done, he said.

He chose to do the rigorous operation because he was disappointed in the longevity of the previous transplant technique he used in twins. The original procedure placed strips of ovarian tissue from the fertile twin into her prematurely menopausal sister.

Two of the recipients have had babies. Stephanie Yarber, Silber's first transplant patient, now has two children thanks to the surgery. She had previously tried egg donation without success.

All of the women who have had the transplants are menstruating and ovulating normally, Silber said. But their ovaries are running out of steam faster than he had hoped. The women may get only two to five years of ovarian function using the strips of tissue, he said.

He hopes that a whole ovary with its own blood supply will last decades.

Silber's success is exciting for people who hope to help cancer patients preserve their fertility, said Dr. Pasquale Patrizio, director of the Yale Fertility Center at Yale University.

Patrizio and others are working on ways to freeze whole ovaries. Right now, women who face infertility because of cancer treatments can have strips of their ovarian tissue frozen and replaced once they are in remission. But no one yet has successfully frozen a whole ovary and transplanted it.

Some reservations

Even Silber's supporters are ambivalent about transplants that would require immune-suppressing drugs because of possible health effects for the mothers and their babies.

Silber said he's pretty sure that low doses of the drugs wouldn't harm a developing fetus. About 2,000 women who are on immune-suppressing drugs because of kidney transplants have had healthy babies, he said.

Lagos won't need to take immune-suppressing drugs because the bone marrow transplant and the close match to Chaney makes her able to tolerate her sister's tissue.

Legal, religious, social and ethical issues that don't apply to other organs may surround ovary transplants, Gimpelson said.

"These other organs are donated to save someone's life. The ovaries are to make
someone's life complete. It's a little bit different," he said.

Silber's critics don't give him enough credit, his colleagues say.

"I look at him as a pioneer. He's willing to push the envelope, but he's also really helping these patients. It's not like he's out there looking for some experimental case," said Dr. David Battaglia, director of the IVF laboratory at Oregon Health Sciences University. "We're getting an idea of what is possible for a whole population of patients. We need people like Dr. Silber to show us the way."

Monday, February 12, 2007

Surrogacy advocates want level playing field

February 10, 2007 12:00am

Stephanie Caballero

Article from: Daily Telegraph

AUSTRALIA'S own baby factory has delivered 27 tots and has 44 more on the way.

The nationwide service which matches egg donors with infertile women is now lobbying for legislative change and says the nation is in urgent need of uniform laws.

Aussie Egg Donors helps donors, recipients and surrogates to navigate Australia's varied surrogacy laws.

They have no age requirements but have a number of older members and a membership of more than 200.

"My first recipient was 51 when her baby was born," Aussie Egg Donor's co-director Rachel Kunde, 25, said.

"Most clinics have a cut off of 50 at time of treatment. There are pretty much no discriminations on our site. We allow all ages."

NSW is one of the few states where surrogacy is permitted and Aussie Egg Donors are now lobbying for universal laws across the country to make surrogacy legal.

Ms Kunde said varying laws between states had boosted membership in recent years with an increasing number of couples turning to the site for information and support.

NSW, Western Australia and the Northern Territory do not have surrogacy legislation.

In Queensland, all surrogacy arrangements are illegal and in Tasmania it is an offence to make or receive a payment and surrogacy contracts are not legally binding.

In South Australia, couples are not legally allowed to enter into a surrogacy contract and in Victoria it is virtually illegal.

Aussie Egg Donors' directors include a women based in Melbourne and another surrogate mother in New Zealand, where surrogacy is legal.

Women Who Donate Eggs for Stem Cell Research Face Few Health Risks, Institute of Medicine Report Says

Bioethics & Science |
[Feb 09, 2007]

Stephanie M. Caballero

Women who donate their eggs for stem cell research or in vitro fertilization are not at increased risk of health complications, and most of the risks are a result of the hormones used to stimulate their bodies to release more than one egg, according to a report commissioned by the California Institute of Regenerative Medicine and released Tuesday by the Institute of Medicine, Bloomberg reports. CIRM decided to assess the risk of human egg donation before administering grants under Proposition 71 to researchers who would use donated eggs (Waters, Bloomberg, 2/7). The process of donating eggs involves inserting a thin needle through the vagina into the ovary. Prior to the usual procedure, donors undergo a course of hormone injections to help the process of obtaining five to 15 eggs (Kaiser Daily Women's Health Policy Report, 10/02/06). These treatments can cause mild pain, slight enlargement of the ovaries and infrequent nausea in the women, Linda Giudice -- chair of the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California-San Francisco and co-chair of the IOM panel that produced the report -- said. Studies of women who used hormones to provide eggs that could be used for IVF found that between 2% and 5% of the women developed ovarian hyperstimulation syndrome. The report said that although most cases of ovarian hyperstimulation syndrome were mild and temporary, in rare cases the condition could lead to serious complications, including kidney failure or death. Fewer than 0.2% of women taking the hormones experience symptoms such as blood clots or reduce blood flow to the kidneys, and about 1.4 of every 100,000 women undergoing fertility treatments experience kidney failure, the report said. Giudice said risk related to infection, surgical complications and anesthesia also are "remarkably low" among women undergoing the procedure. Data did not show that the women are at increased risk of breast or ovarian cancer but there was too little information to assess the risk of uterine cancer, she said. Giudice added that the data are rough estimates of the risks involved in egg donation because women who have donated eggs in the past have not been tracked for long periods of time. Members of the IOM panel suggested that researchers continue tracking women who donate eggs and collect that information in a database (Bloomberg, 2/7).

Australian Couples Breaking Surrogacy Laws

Infertile couples desperate for children are risking their health and breaking the law by using home insemination kits.

Members-only websites link would-be parents with egg donors and surrogates, News Ltd newspapers report.

An increasing number of couples were breaking Australia's strict and complex surrogacy laws, according to the managers of Aussie Egg Donors, an online service and support group.

Co-director Rachel Kunde said differences in the law between states were forcing couple to use DIY insemination methods.

"In some cases people get really desperate ... home insemination happens a lot, I know of at least a dozen surrogates who have done it that way," Ms Kunde told News Limited.

Recent high-profile surrogacy cases have boosted the number of Australian couples willing to break the law, according to an NSW group.

The director of the group, described only as "Cindy", described her network as like "a secret society" and that there were "always ways around laws".

Sandra Dill, executive director of infertility consumer group Access Australia, said DIY surrogacy carried health risks.

There are no surrogacy laws in NSW, Western Australia nor the Northern Territory but in Queensland all surrogacy arrangements are illegal.

In Tasmania it is an offence to make or receive payments while surrogacy agreements have no legal status.

In South Australia, couples are not allowed to enter into a surrogacy contract, while in Victoria it is all but illegal.

© 2007 AAP

Gay Actor Considering Surrogacy

When looking for good queer role models we need to call the Doctor. Doctor Who? Yes. Captain Jack the 51st century companion of the Doctor played by John Barrowman is out and proud of his sexuality, wants to have children and is out-spoken on gay marriage.

Barrowman is open and relaxed when talking about his sexuality. "I've known I was gay since the age of eight or nine," he says. "Back then, though, it was more a feeling that there was something different about me than perhaps specifically knowing what that was. But what's the big deal? I'm 38, I work in musical theatre and I live with another guy. It's the 21st century: we're all human beings and individuals. If someone has a problem with it ? Well, they can go and piss off. I don't want to be around them."
That said, he was 22 before he came out to his parents, making a special trip to Illinois to break the news. "I don't want to say they were shocked ? my mother turned to me and said she knew, and I think perhaps my dad knew too ? but I think every parent is a little surprised. My dad said, 'I don't really understand it right now, but give me a little while to learn more about what you're telling me and I will.' He also said, 'It's absolutely fine with me, though, because what you do in the privacy of your own bedroom is your own business, just like what your mother and I do. We don't tell you about it.'"
Barrowman pauses, his eyes earnest. While he wears his heart on his sleeve, he also points out that, personally, he doesn't feel the need for deliberately public displays of sexuality. He is an ardent supporter of the Gay Pride movement and everything it stands for, but explains: "My parents have always brought us up to believe that sex and sexuality are something to be proud of, and you don't have to flaunt it if you don't want to. People don't walk around with a banner saying they're straight, so why should I walk around with one saying I'm gay? I understand there are people who want to and need to make that statement, and I appreciate that, but don't come down on me because I'm not one of them."
Gay marriage is another topic guaranteed to raise his hackles. "OK, this is where I get political," he says. "People keep asking me if I'm going to do it. The answer is no. I was brought up in a family which believed there was a God who created us. I believe that God created me this way for a reason and he's not a god who hates, dislikes or is against the way I live my life.
"That said, there is organized religion that says gay men and women are wrong, bad, evil ? whatever you want to call it. So why would I want a 'marriage' from a belief system that hates me?"

Barrowman has been with his partner Scott Gill, an architect, for 14 years. Both of them, he says, want to have children (although Barrowman admits "I'm more keen than Scott is"), and have discussed adoption and surrogacy as potential options. A friend has offered to be a surrogate mother for the couple. "I'm best friends with her mother, and the woman herself has known me like a brother since she was five," says Barrowman. "We've spent many days and vacations together." Yet he is deliberately sketchy on the details. She's 28, American and a dental hygienist, and is married with one-year-old twins. Her husband has also given the green light to the plan. "She's said that when we're ready, just send her an e-mail," says Barrowman.
While he won't rule out adoption, it's clear he views surrogacy as the more appealing option. "I'd very much like to have a child of my own," he says. "Scott and I have talked about it and said that if we decide to use a surrogate mother, we would mix the sperm so we wouldn't actually know whose the child was and it would still be part of both of us." The only thing his friend has asked for in return, he says, is that he would take care of her mortgage while she was off work. "I said of course I would."
He and 42-year-old Gill, whom he describes as "looking like an Armani model", met when Barrowman was in a play at the Chichester Festival Theatre, shortly before his Live and Kicking debut. A mutual friend had coaxed Gill to the play by telling him that Barrowman was naked for the first seven minutes. "I always joke that he saw what he getting from the outset," the actor says. And it was love at first sight ? well, almost.
"Scott came into the dressing room while I was getting dressed," says Barrowman. "I was bending over to pull my pants up, so the first thing he saw was my bare bum. Then I turned around and saw him. At that very instant, in my head, I said, 'That's him. That's the one.' And he says he was thinking the exact same thing.” Though he proved a big hit in Doctor Who, Barrowman's Captain Jack will not appear in the fervently awaited Christmas special, starring Billie Piper alongside David Tennant as the new Doctor. Yet he hardly seems broken-hearted, and is full of assurances that he will return to the show in the future ? hinting it could be sooner rather than later. "I will be coming back," he says. "But no date has been set. That's the official answer." He gives an exaggerated wink before collapsing in laughter.
Either way, there's little doubt his role in Doctor Who has been a career high so far. "It was an absolute dream come true," he says. "I believe everyone should have a goal and a dream. That was one of mine. As a child I used to dream of appearing in Doctor Who, but I never thought it would happen. I was cast at the beginning, at the same time as Billie [Piper] and Chris [Eccleston], but I had to keep my mouth shut for nine months. I couldn't tell anyone other than close family. My niece was shopping with me in Covent Garden when I got the call to say I had the part. I screamed the place down: I was jumping around everywhere. This woman came up to ask what was happening. I had to say, 'I cannae tell you.’ “Captain Jack is a somewhat sexually ambiguous character, billed as an archetypal "51st-century man". From a personal standpoint, Barrowman is a man comfortable in his own skin, equally happy as a pin-up for teenage girls and gay men alike. "I'm happy to be a people's fantasy ? men and women," he says. "I've been getting letters from married couples, and at the end of it the husband will put a little PS saying something like, 'My wife and I have talked about it, and if there's anyone who could turn me it would be Captain Jack.’ “Barrowman is now gearing up for his role in the stage production of A Few Good Men in the West End, where he will star opposite the American actor Rob Lowe. "If you've seen the movie, I'm the Kevin Bacon part and Rob Lowe is the Tom Cruise part," he says. "There's no sex scene, though." And he looks wistful and gives a mock sigh.
A Few Good Men is at the Theatre Royal, London, from August 18. Doctor Who, the complete first series box set is out November 21.

Wednesday, February 07, 2007

Surrogacy Center Case Dismissed

Surrogacy Center Theft Case Dismissed

Birth broker for gays and singles was accused of stealing a client's $6,500

Stephanie Caballero
By Sam Wood

Theft charges were dismissed yesterday against the director of a former South Jersey agency that brokered surrogate child births.

Len Brooks, 37, ran the MidAtlantic Center for Surrogacy & Egg Donation, which listed a Cherry Hill post office box as its address.

Brooks had been accused of stealing $6,500 from an Evesham Township man who paid Brooks $24,500 to find a woman who would give birth to a child for him. Brooks failed to find a woman or provide a refund, the man said.

Brooks mailed $18,000 to Evesham police to give to the man. Brooks said the $6,500 was nonrefundable agency fees; prosecutors disagreed.

At a hearing yesterday, Brooks and a friend erupted in laughter when lawyer Donald Manno stepped from the judge's chambers to tell his client that the motion to dismiss the theft charges had been accepted.

State Superior Court Judge John A. Almeida took the bench a few minutes later. Almeida said the charges had been dismissed because of "exculpatory evidence" related to the contract.

The case could still be pursued in civil court, said First Assistant Prosecutor Raymond E. Milavsky.

"We had concerns with this case and this victim only," Milavsky said. "We have talked to the victim, and he understands."

At least 17 other people have contacted the prosecutor's office with complaints about Brooks' business dealings, a prosecutor's spokesman said.

According to Brooks' Web site, he manages surrogate arrangements for primarily single or gay clients in "Europe, Asia, Australia and South America."

Brooks, formerly of Sewell and Sicklerville, moved to Florida in 2005 and opened another agency, International Surrogacy Consultants. Through his lawyer, he declined yesterday to say where his newest agency is based.

Manno, who had contended the Evesham man had used the prosecutor's office as a collection agency, said Brooks had been unfairly targeted by many disappointed childless couples who had staked their hopes on Brooks' providing them with a child.

"You're probably aware of Lenbrooksthecrook.com," Manno said. "There's an incredible amount of venom by disgruntled people looking for someone to blame for their misfortunes. He gets the brunt of it."

Manno said he and Brooks were considering filing a countersuit against the Evesham man for withholding documents, as well as suits against others for making false statements.

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