Transplanting motherhood

Saturday, October 16, 2004

ST. LOUIS -- Stephanie Yarber had her first bout of morning sickness Friday, but she's not complaining. The nausea only confirmed what she had dreamed would happen some day.

The Alabama woman, who came to St. Louis in April to have the first known ovary transplant in this country, is pregnant. Five weeks and four days to be precise.

"I just cried and screamed," she said by phone from her home in Muscle Shoals, Ala.

Yarber, 25, hasn't had a period since she was 13, dashing any hopes of having children. Her identical twin, Melanie Morgan, of nearby Tuscumbia, Ala., has three little girls.

Yarber unsuccessfully had tried in vitro fertilization twice, using eggs donated by her sister.

In April, the sisters underwent a rare operation at St. Luke's Hospital, in which ovarian tissue from Morgan was transplanted into Yarber in an effort to make her fertile.

Dr. Sherman Silber, who led the transplant team, said at the time he expected Yarber to begin menstruating in three months and hopefully become pregnant "the old-fashioned way."

By September, she had a normal period and medical tests indicated that she had ovulated.

By Oct. 5, antsy for an answer to her wildest dream, Yarber headed to the pharmacy for a home pregnancy test. Unaccustomed to seeing positive results, "I panicked, and started shaking, and went to a hospital to find out," she said.

The lab report took a couple of hours, and Yarber was back at her customer service job at a bank when she got the call.

"My doctor said, 'Are you sitting down? You're pregnant.' I just cried and screamed, and everybody in my department knew."

When Yarber got off work, she called her sister by cell phone from the car. "She went nuts," Yarber said. "She kept screaming, 'Praise the Lord!' and crying. Then Mama got on the phone and started screaming, 'My baby's pregnant.' "

Yarber said an ultrasound, performed Thursday made the pregnancy a little more real to her and her husband, Kevin.

She talked to Silber by phone last week, and he told her his staff screamed for joy when they heard the news.

"I had faith it would happen, but later asked myself, what if it doesn't work?" she said.

"That's where you've got to let go and let God. After years of praying and wanting kids, we're just delighted. We couldn't be any happier."

In the twins' five-hour operation on April 21, gynecologist Dr. David Levine removed one of Morgan's ovaries and passed it to Silber in another room, where he removed its outer tissue rich with egg-producing follicles. Through a small incision, he sutured the tissue to each of Yarber's nonproducing ovaries.

A St. Luke's spokeswoman said no one would comment until Silber's research paper on the procedure is published in a medical journal next week. She wouldn't name the journal.

Last month, in Brussels, Belgium, a woman gave birth to the first baby conceived after an ovary tissue transplant -- in this case her own ovary. Seven years ago, the woman had lymphoma and needed chemotheraphy so her ovarian tissue was removed and frozen. Five years after she was cleared of cancer, the tissue was transplanted.

And more than a year ago in China, surgeons at Zhejiang Medical Science University reported a successful whole ovary transplant between sisters.

The apparent success of these transplants offers hope to women who must delay pregnancy for health reasons or, perhaps someday, for merely personal reasons.

But Silber believes Yarber's unusual case offers other research opportunities.

He wants to isolate the gene that caused Yarber to become menopausal at age 13, something that could aid scientists in their study of infertility.

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