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New Ovarian Transplant Technique Could Expand Use Of Procedure To Preserve Fertility
Two recent advancements in ovarian transplant techniques could potentially expand the availability of the procedure for women seeking to avoid fertility problems as they age, researchers reported Monday at a meeting of the European Society of Human Reproduction and Embryology, the AP/Yahoo! News reports. According to the AP/Yahoo! News, ovary transplants traditionally have been performed on women with cancer as a method of preserving fertility after chemotherapy or other treatments that can affect the reproductive system. The procedure involves removing the ovaries before treatment and re-implanting them after treatment is complete. Because only a handful of these procedures have been successful, ovarian transplants have been an option only for women with serious diseases. However, as more women delay having children until their 30s or 40s, researchers say the new techniques, in theory, could make it simpler for healthy younger women to have an ovary removed, frozen and then re-implanted later in life when they are ready to have children.The first study examined how many eggs were lost or preserved in fresh and frozen ovarian tissue of 15 young women prior to the start of cancer treatment. According to the study, there was no difference in the quantity of eggs in the fresh tissue and in the ovaries frozen using a new ultra-fast technique. The study found that about 50% of a woman"s eggs were lost using the traditional, slow-freezing methods of preserving the ovaries.The second study reported on a new surgical technique to restore an ovary"s function after transplantation. For the study, Pascal Piver of Limoges University Hospital and colleagues divided the transplant process into two separate procedures in an attempt to more quickly re-establish blood and hormone supplies to the ovary. In the first procedure, the researchers performed a graft of small pieces of ovarian tissue to prompt blood vessels to grow. They performed the ovary transplant three days later. The technique was successful in a woman who lost fertility because of treatment for sickle cell anemia.Sherman Silber, director of the St. Louis Infertility Center in Missouri and a researcher for the first study, said the new techniques "could dramatically expand our reproductive life span." He added, "This is not an experimental procedure for cancer patients anymore. The question is whether more women should be able to have this option" (Cheng, AP/Yahoo! News, 6/29).
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Closing Speech Of The World Health Assembly
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News of the day
Food And Drug Administration Moves Towards Greater Openness
The Food and Drug Administration is taking steps towards greater openness. The Associated Press reports that FDA Commissioner Margaret Hamburg "announced Tuesday she has created a task force to make recommendations on how the agency can release more information in such areas as drug evaluation and enforcement matters. She wants a report in six months." Deputy Commissioner Joshua Sharfstein will head the task force, which will represent all of the FDA"s major divisions as well as its law enforcement branch. It will hold two public meetings with the first on June 24. "The FDA has long operated under strict confidentiality rules," the AP reports, and in opening up information, one sensitive issue will be what to do with unpublished clinical trial data from drug manufacturers. Despite such concerns, "Hamburg said she believes the need for secrecy may have been taken too far, and is harming the FDA"s credibility within the medical community and among consumers" (Alonso-Zaldivar, 6/2).
Diagnostics

Babies With Mild Facial Paralysis From Forceps Typically Do Not Need Treatment

Mild facial nerve paralysis caused by the use of forceps during birth generally resolves on its own and does not require treatment, according to a report in the July issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals. Facial nerve palsy (inability to move some facial muscles) occurs in approximately 0.8 to 7.5 of 1,000 births overall and 8.8 of every 1,000 births in which forceps are used, according to background information in the article. "Previous observations indicate that while most cases of facial nerve palsy caused by birth trauma implicate the use of forceps, up to 33 percent occur in spontaneous vaginal delivery without instrumentation," the authors write. The injury is caused when the forceps blade or a bone in the mothers" pelvis puts pressure on the baby"s head in the area of the facial nerve. Melanie Duval, M.D., of McGill University, Montreal, Quebec, Canada, and Sam J. Daniel, M.D., M.Sc., F.R.C.S.C., of McGill University and Montreal Children"s Hospital, reviewed the medical records of 28 babies with facial nerve palsy caused by forceps use between 1989 and 2005. In all 28 cases, the palsy was classified as mild to moderate. "Except in one neonate, no treatment was initiated in any of the patients," the authors write; one child received a 14-day course of oral prednisone, a corticosteroid. "All 21 neonates with adequate long-term follow-up recovered fully after an average period of 24 days." "There is discrepancy in the literature on the investigations and/or treatment options to be undertaken in facial palsy owing to birth trauma," the authors conclude. Some authors recommend surgery to explore the nerve, whereas most consider observation to be sufficient in uncomplicated cases. The current results add to evidence that the recovery rate is high without treatment. "This confirms that corticosteroid treatment or surgery should be withheld in neonates presenting with uncomplicated facial nerve palsy resulting from forceps trauma." Arch Otolaryngol Head Neck Surg. 2009;135[7]:634-636. Archives of Otolaryngology-Head & Neck Surgery


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