An Astonishing Breakthrough in Belgium
When Ouarda Touirat went to her doctor in the summer of 1997 complaining of weakness, weight loss and a missed period, the diagnosis was a terrible mix. Touirat, a waitress, was pregnant—and she had potentially lethal stage IV Hodgkin's lymphoma. Forced to terminate the pregnancy and facing the likelihood that cancer treatment would leave her sterile, Touirat, then 25, and her husband, Malik Bouanati, 34, were inconsolable. "What woman doesn't want children?" she says. "But we had to take care of the cancer first."
Then Jacques Donnez, head of gynecology at Brussels' Cliniques universitaires Saint-Luc hospital not far from the couple's home, told them about a startling new procedure. Researchers in other countries (including the U.S.—see box) had been experimenting with removing healthy ovarian tissue from cancer patients and freezing it for use after chemo and radiation. While the method so far hadn't resulted in a successful pregnancy, the doctor told Touirat that if she made a good recovery from her illness there was a chance her ovarian tissue could be transplanted back into her body—and could begin producing eggs again.
Donnez cut tissue from both of Touirat's ovaries. "It was no big deal," she says. "Very little pain." More grueling were the courses of chemo and radiation that she endured over the next five months. Happily, in 2001 Touirat was well enough to attempt pregnancy—but with no luck. After two years, when she started showing signs of early menopause, she knew it was time to try the transplant. Early last year Donnez created a pocket between the end of the fallopian tube and Touirat's atrophied right ovary and then implanted her cryopreserved ovarian tissue. Four months later she began producing eggs and with no further help from her doctors became pregnant. On Sept. 23, with the first birth of its kind anywhere in the world, the pair welcomed healthy 8 lb., 3 oz. Tamara Sarah. Some experts say Donnez's technique needs further study. But not Touirat. "I had seven years of bad luck," she says. "Now things have changed."
Expecting—thanks to cutting-edge surgery
Although she was three months pregnant during her vacation on a Florida beach last March, cancer survivor Patricia Kirkland had no hesitation about sporting a skimpy turquoise bikini. "I wasn't going to wear one of those big ugly things with a skirt," says the 37-year-old New York City hairdresser. "I wanted everyone to know I was pregnant."
Little wonder, after all she's been through. Diagnosed with cervical cancer after a routine pap smear in June 2000, the British-born Kirkland rejected the idea of any treatment that would prevent having children. "I was really scared," she says. "I kept hearing the word 'hysterectomy' " Instead she opted for a new procedure called a radical vaginal trachelectomy. So far performed on only 300 patients worldwide, the technique involves removing most of the cervix and the vagina but leaving the uterus intact so that, if all goes well, the patient can carry a pregnancy to term.
The procedure's French pioneer, Dr. Daniel Dargent, operated on Kirkland in September 2000 in France, where she was visiting the family of her boyfriend, Jean-Baptiste Humbert. "That's when I knew he was the one," says Kirkland, who had met Humbert on vacation a year earlier. "He was with me 150 percent." The pair married in November 2000 and, amazingly, Kirkland became pregnant last December. "I couldn't believe it," she says. Neither could Humbert. "I always thought that it wasn't going to happen," says the 30-year-old furniture-shop owner.
For trachelectomy patients, "fertility is somewhat diminished," says Kirkland's obstetrician Dr. Andrei Rebarber, "but the main issue is preterm labor." To lower that risk, Kirkland's remaining cervix was reinforced by a single stitch to keep it closed. The procedure worked: the couple's son Finn was delivered by cesarean on Sept. 14. Throughout the pregnancy, proud papa Humbert vowed that someday their baby would be bilingual. For now, Kirkland is happy just with his cooing. "He's beautiful," she says. "And he's fine."
These twins may help save a brother's life
After a routine blood test 16 weeks into their first pregnancy, Minni and Jimmy Powell were devastated to learn that their baby might be born with sickle-cell anemia. "I cried hysterically," says Minni, 37, an accountant who emigrated to the U.S. from India at age 9. "We were told, 'You will have a sick, sick baby." They did. Son Tej Neaz, born in 1998, has gone through a lot: terrible pain, repeated hospitalizations and the prospect of a disease that could kill him in his 40s. His parents have suffered too. "When I felt I was going to lose it," says Minni, "I retreated to the bathroom to cry."
But she and Jimmy, 37, who creates emergency-response programs, didn't shrink from trying to have another, healthy child. The Powells found out about a type of IVF known as ICSI, in which a single sperm is injected into an egg. Then, in a second process called preimplantation genetic diagnosis (PGD), the embryo is analyzed for defects. If none are found, the embryo is transplanted into the mother. The technique, used by perhaps 1,500 fertility patients a year, "is like a preimplantation amnio," says the Powells' physician Kenny Steingold. "It's cutting-edge."
But the procedure's real bonus came when the Powells learned that another baby might actually help their first child. Stem-cell transplants have cured some sickle-cell patients, and if the Powells' new baby was both healthy and a perfect match, his cells might one day be used to treat Neaz. "We wanted more children regardless," says Minni. "But it was also in the back of our minds that this could save Neaz's life."
It took three PGD attempts, but last fall Minni discovered she was not only pregnant but carrying healthy twins. Jaya and Vijay were born June 3, and their stem-cell-rich umbilical-cord blood is stored in case Neaz ever gets sick enough to need it. In the meantime the Powells are done having kids. "This," says Minni, smiling, "is enough."
An Iraq War widow keeps love alive
Linda Torres and her husband, Richard, an Army second lieutenant, had been working on having a baby for eight months, when their infertility specialist brought up a delicate issue. "He said, 'Since Richard is leaving for Iraq, he should have something frozen,' " says Linda," 'because you never know what will happen.'"
By last August, Linda, then a student, and Richard, both 25, had been through two unsuccessful intrauterine insemination attempts. On the advice of their doctor, Eric Knochenhauer, director of infertility at Staten Island University Hospital, they were ready to try IVF.The decision to freeze Richard's sperm didn't mean "we were thinking the worst," says Linda. "Just that he might be overseas longer than we thought." Then on Oct. 6, not even five weeks after he had shipped out to Iraq, Linda got the unthinkable news: Richard had been killed when his Humvee was ambushed in the Iraqi town of Al Iskandariyah. Even now, she says, "I can't go back to that day."
Today she wears Richard's wedding ring around her neck, along with his dog tag. She also carries another memento from the man who was her high school sweetheart, and whom she still calls "my hero." In the wake of her first IVF on June 17, she's 15 weeks pregnant and due March 10. "The love I had for Richard, I didn't know what to do with," she says. "Now I can give it to his baby."
A later-in-life dad
As 40-something newlyweds, Karmella and David Lee knew having a baby wouldn't be easy—but they never expected David's age to be the obstacle. A fairly new technique called a sperm DNA integrity test revealed that sperm from the 46-year-old neurologist, who had fathered two children in a prior marriage, were now damaged from stress and aging. "You don't just look at how sperm wiggle," says their fertility specialist Dr. Geoffrey Sher. "You have to look at the sperms' DNA integrity."
David discovered that 38.9 percent of his sperm were immature, versus 10 percent in a normal patient. After the Medford, N. J., couple rejected the idea of a sperm donor, Sher put David on an intense two-month antioxidant regimen of vitamins C and E. Then he used the intracytoplasmic-sperm-injection technique, forcing an individual sperm into each egg. Remarkably, two weeks later the Lees found out they were expecting twins. "We were elated," recalls Karmella, 44, who gave birth to Jordan and Ariela last Oct. 30. "I think the entire county could hear me scream."
Another shot at parenthood? They banked on it
High school sweethearts Craig and Mindy Morehouse knew all about the difficulties of trying to have a baby with help from a doctor. To become pregnant with their first child, Mindy, then a fourth-grade teacher, had fertility shots. Each day she injected herself just under the skin of her stomach with a drug to boost her production of eggs. Another shot, administered by her doctor, forced the mature eggs to leave the ovaries, allowing the couple from Crawfordsville, Ind., an 18- to 36-hour window in which to conceive naturally—with brilliant results. Riley, now 6, is a bright and bouncy first grader.
But when the Morehouses decided to try for another child in 1998, "it was a roller coaster," says Craig, 33. "One month we'd be excited, and then it would fail," says Mindy, 32. The fertility treatment they'd used before simply didn't work: Because of a hormone deficiency, five attempts at artificial insemination resulted in two miscarriages. "It was very discouraging, but we really were not going to stop until we had another baby," Mindy says.
The next obvious step was in vitro fertilization, in which eggs are fertilized with sperm in a laboratory. Because of the difficulty, doctors prefer to fertilize large batches of eggs at one time, freezing the embryos for future use. But the Morehouses had moral objections: They consider embryos to be the beginning of life, and since those not used for implantation are eventually destroyed, they couldn't proceed.
Instead, the couple took a far less reliable option: freezing Mindy's eggs. The Morehouses don't consider eggs, with just one cell, to be a form of life. So in October 2002 Mindy again took drugs to stimulate ovulation. From the 22 eggs removed and frozen at the Indianapolis offices of Dr. Donald Cline, three were inseminated and placed in her uterus, resulting in twins Mallory and Ryan, born June 30,2003.
Fewer than 100 babies have been born from frozen eggs since the practice was first attempted in the early '90s, in part because the freezing process can damage the eggs. While many doctors warn that this could lead to abnormal births, others see egg freezing as a development still in its infancy. "For women who are going to be treated with chemo or radiation, it gives hope to be able to bank their eggs," says Cline, who has achieved 11 pregnancies in 34 patients. "I think the future is quite bright."
So is the outlook for Mallory and Ryan Morehouse. Because of stress on Mindy's right kidney, the twins had to be delivered by emergency C-section at 36 weeks. Ryan tore a hole in the lining of his lungs when he took his first breath and stayed in the hospital for two weeks. Dad passed out in the delivery room. But today, as the rambunctious pair tear through the couple's four-bedroom house set in a cornfield, "Mallory is dynamite, and Ryan is just beautiful," says Mindy. "We went through a lot of sleepless nights, but we have our babies."
Susan Horsburgh and Susan Schindehette. Giovanna Breu in Chicago and Crawfordsville, Joanne Fowler in Medford, N.J., Macon Morehouse in Richmond and Jennifer Frey in New York City
- Giovanna Breu,
- Joanne Fowler,
- Macon Morehouse,
- Jennifer Frey.