When Sarah Gardner was 34, she started getting worried about whether she'd ever have a baby. So she took a test that aims to measure a woman's fertility.
The results terrified her. They indicated she had the fertility of a woman a decade older — a woman in her mid-40s.
"I was devastated," Gardner says. The news hit her especially hard because she was in the midst of breaking up with her longtime boyfriend.
"I knew that being a mom was something I wanted in my life," she says. "And I knew that it would be very difficult to achieve that, given that I was about to be single. So, yeah, I was devastated."
In her hunt for a solution, Gardner eventually found Dr. Sherman Silber, a surgeon who runs the Infertility Center of St. Louis. As Shots reported in 2012, when we first met Gardner and her doctor, Silber does something controversial among infertility specialists — he removes and freezes the ovaries of healthy women to put their biological clocks on hold.
The idea is that the ovaries can then be thawed and returned to the women via surgery when they're ready to try to have children.
Gardner, who lives in Australia, discussed that option with her twin sister, Joanne, who lives in London. Joanne was also worried about running out of time to have kids. So both sisters decided to undergo the procedure, as a hedge against their dwindling fertility odds.
"What it gave us was huge amounts of relief," Sarah Gardner says. "It really just took a huge weight off us."
Today the Gardner twins are 44; Sarah just got engaged and wants to finally try to have a baby. She and Joanne both returned to St. Louis in June to get their ovaries reimplanted.
"It's weird," Sarah Gardner says. "It's like we went in a time machine — a fertility time machine. It's amazing."
Not only do the sisters hope their reimplanted ovaries will help them get pregnant, they are also hoping the procedure will reverse their menopause.
"I'm really excited," Sarah says. "It will be really nice to not have another hot flash."
The approach was originally developed for women who are being treated for cancer and hope to preserve their fertility but don't have time to freeze their eggs. Some cancer treatments can destroy fertility.
Although removing ovarian tissue (or an entire ovary) and preserving it, then reimplanting it years later has produced promising results for such women, it remains far from clear how often the multistep procedure works. It's still considered experimental. The Gardner sisters may be the first women without a history of cancer to have undergone it, according to Silber.
Egg freezing, on the other hand, has been studied more extensively. And many experts say egg freezing, with its far from certain success, is much safer than going through two surgical procedures to have an ovary removed and later reimplanted.
Dr. Glenn Schattman, an associate professor of reproductive medicine at the Weill Medical College of Cornell University, says recommending ovarian freezing for women who don't have cancer is "irresponsible."
But Silber says freezing, thawing and reimplanting an ovary is easier, more reliable and safer than egg freezing; typically, harvesting the ovary and reimplanting it can both be done on an outpatient basis, he says.
Moreover, when an entire ovary is frozen, women don't have to undergo the weeks of hormonal injections required to ripen the multiple eggs that are extracted when the eggs are to be frozen, Silber says. And the total cost of the procedure to remove, freeze, thaw and and reimplant and reattach an ovary — less than $3,000 — is much lower, he says, than the cost of going through several attempts to collect eggs for freezing.
"There are huge advantages to this," Silber says.
Meanwhile, the Gardner sisters are once again home in Australia and England. They're both waiting for their periods to start again and hope to be pregnant by the end of the year.
"Wouldn't that be nice?" Sarah Gardner says, adding that she and her sister realize that the doctors can't guarantee success.
"We're going to leave it up to the gods or the universe," she says, "and see what happens."
RENEE MOTAGNE, HOST:
A doctor in St. Louis is trying to help women give birth later in life by freezing their ovaries - not just their eggs, but their ovaries. This is controversial and considered risky by some. But now twin sisters have become the first healthy women to test if the procedure will work. NPR health correspondent Rob Stein has their story.
ROB STEIN, BYLINE: When Sarah Gardner was 34, she started to worry whether she'd ever have a baby. So she got her fertility tested.
SARAH GARDNER: My fertility was something like 10 years older than me. So I was 34 and it was 44, which was really shocking news and very scary.
STEIN: Especially scary because she got the results just as she was breaking up with her boyfriend.
GARDNER: I was devastated, I was because I knew my relationship was about to end. And I knew that being a mom was something I wanted in my life. And I knew that it would be very difficult to achieve that given that I was about to be single. So, yeah, I was devastated.
STEIN: She eventually found a doctor in St. Louis who was removing and freezing women's ovaries to put their biological clocks on hold. So Gardner and her twin sister, who was also worried about running out of time to have kids, decided to do it together.
GARDNER: What it gave us was huge amounts of relief. We just sort of felt I could get on with my life without having to think about fertility. And it really just took a huge weight off us.
STEIN: Fast forward to today. Gardner's now in her mid-40s. She just got engaged and wants to finally try to have a baby. So she and her sister traveled back to St. Louis last month to get their ovaries thawed out and transplanted back in.
GARDNER: It's weird. It's like we went in a time machine - a fertility time machine. It's amazing. It honestly does feel like a scientific miracle.
STEIN: Because they don't just hope their transplanted ovaries will let them get pregnant. The ovaries should also reverse their menopause.
GARDNER: Oh, I'm excited. Yeah, I'm really excited. And it'd be really nice to not have another hot flash ever again. And it'd be nice to, yeah, to go back to being 36 again. It'd be really nice.
STEIN: Now, all this might sound pretty great. But not everyone's so sure. Here's why. The procedure was originally developed for women who have no alternatives because they're being treated for cancer and don't have time to freeze their eggs. Glenn Schattman is a reproductive specialist at Cornell.
He says it's far from clear how often it works. And egg freezing is a lot safer than going through two surgical procedures to have an ovary removed and later put back in.
GLENN SCHATTMAN: I think in today's day and age with what we know about egg freezing and what we know about ovarian tissue freezing and the risks involved in each of the two procedures, I would say it would be irresponsible to recommend this to anybody for elective fertility preservation.
STEIN: But Dr. Sherman Silber, who's offering the procedure at his clinic in St. Louis, argues it's much more reliable, easier and actually safer than egg freezing.
SHERMAN SILBER: With this procedure, it's all done in a half an hour. No medications before, no medications after and they're done. I mean, they go home and they don't have to think about it anymore. It's, like, 20 minutes and they're done. And the whole cost would be maybe $2,000 at most or $3,000. They're not going to have a bill for 50 or 60 or $70,000 dollars.
So there are huge advantages to this.
STEIN: Sarah Gardner agrees. She's back home in Australia. And her sister is back in England. They're both waiting for their periods to start again and hope to be pregnant by the end of the year. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.