Our advice will be up to 35 for fertility preservation and possibly up to 40 for hormonal preservation. However, any final decision can only be taken after a few ‘ovarian reserve’ tests are undertaken, following a consultation. These tests involve hormone evaluation and an ultrasound scan of the ovary. Danat Al Emarat is designed for different groups of patients including cancer patients; those with benign but severe conditions that require pelvic surgery (such as non-cancerous ovarian tumours, those suffering from a torsion or severe endometriosis); endocrine and genetic conditions or autoimmune disorders.
Your preserved ovarian tissue can be used in the future for the availability of eggs should you need them, or simply to provide your own, natural hormones to delay the onset of the menopause. Using ProFaM may enable you to maintain your pre-menopausal state of health and wellbeing for an additional 10 or 20 years."
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For hormone replacement use of the tissue only we have various strategies to ensure that you will not become pregnant, which does not involve taking drugs or medicines. For example, the tissue can be grafted back to an area from which it is not possible to conceive, but hormone production remains uninhibited. When you wish to have the tissue reimplanted, the timing will be your choice with the guidance of your consultant. And the location within your body you transfer the tissue depends upon individual circumstances, and as there are a number of options. Your particular situation needs to be discussed with your consultant.
If you prefer not to have menstruation post tissue reimplantaion, then these can be prevented, again without the need of drugs, and this needs to be fully discussed with your specialist.
There is no evidence that ovarian surgery affects the future ability to conceive. We use the microsurgical principles through a key hole surgery which is known to reduce the risk of any scar formation significantly.
The risk of cutting blood supply is very low, but should this happen, or there is an effect of freezing, you will end up losing some of the follicles existing in the tissue. However, depending upon your age there should be a large number of follicles so you will still have enough follicles to function as normal
This depends upon individual circumstances, and as there are a number of options. Your particular situation needs to be discussed with your consultant.
For those who want to understand about getting pregnant, from the many cases done over the years, the data indicates that around 50% of patients can conceive naturally following tissue reimplantaion/grafting, whilst the remainder will need IVF.
Large studies which looked at the age of menopause for those having a whole ovary removed did not reveal any significant increase in the risk of early menopause.
Studies which looked at the long term follow up of patients having significant part of the two ovaries removed did not reveal significant risk of compromised ovarian function.
Approximately only 1% of the ovary is used for ovulation and there is an adjusting mechanism of the rate of the loss in the function of the ovary in case of surgical removal of part of the ovary.
ProFaM has developed a technique aiming to significantly eliminate this theoretical risk of compromising the ovarian function. The technique entails: Removal only of 1/3-1/2 of the outer layer of one of the 2 ovaries Avoid use of any excessive ‘diathermy’ (the standard procedure of heating surrounding tissue to stop bleeding) which might compromise the remaining tissue Removing only the outer layer which has very low blood supply to avoid any bleeding Use of certain agent to minimise any risk of bleeding
The laparoscopy (key hole surgery) is commonly performed and quite a safe procedure. The risk of the procedure depends on many factors which requires medical assessment. Minor complications are estimated to occur in 1 to 2 out of every 100 women. These are usually self-limiting and resolving, including shoulder tip pain, wound infection or minor bruising.
Serious complications are estimated to occur in 1 out of 1000 cases. These include: injury to the bowel or blood vessel. This injury can be fixed through the laparoscopy or through a bigger cut. There is very remote risk of clotting in the leg or the lung, and appropriate preventive measures will be taken to reduce significantly such risks.
No medical procedure can offer a guarantee on outcome, but the chances of success have been presented in the medical-science literature, in our Patient Information Document and will depend upon individual circumstance, such as your age.