In monozygotic twin pair ovarian transplantation has shown to re-establish ovulatory function (Silber, 2009).Outcome of fresh and cryopreserved ovarian tissue transplantation was represented by seven healthy infants out of ten pregnancies. This research was conduct on a series of monozygotic twin; the twin donor naturally did not present premature ovarian failure. All the receivers of this research study after treatment presented a normal ovulatory menstrual cycle and in one study the cycle stopped after 3 years (Silber, 2009). Can ovarian transplantation be the future treatment for spontaneous premature menopause? The answer is …very unlikely because the outcome probably would have not been the same between heterozygote twins. Nowadays the problem of recipient immune system attack to the transplanted organ or tissue still exits. Immunosuppressive drugs are mandatory to prevent organ rejection.

Early menopause not only increase the risk of cardiovascular diseases, osteoporosis and psychiatric diseases but recently studies have shown that in women with IBS (Irritable Bowel Syndrome) it may be responsible for increase gastrointestinal symptoms (Heitkemper and Chang, 2009).Some women experience severe abdominal cramps around the time of early menopause, this event occurs when lowering or withdrawal of estrogen and progesterone are detected (Heitkemper and Chang, 2009). Hormonal replacement therapy (HRT) may reduce hormonal deficiency symptoms but may not eradicate all the unfavorable outcomes derived from the use of synthetic or non species specific hormones. Additionally HRT does not solve the problem of infertility in women of young age with early menopause. Cryopreservation of ovarian tissue for fertility preservation is a possible option for cancer patients before chemo treatment (Donnez et al 2009). However further studies on strategies to regain ovulatory function in women with unpredicted premature natural menopause are needed to improve human assisted reproductive technology.

Recent in vitro research study showed that ovarian surface epithelium (OSE) stem cells may produce new eggs, also when these cells are extracted from ovaries deficient of primary follicles. As a result theoretically, new eggs from human somatic stem cells subjected to in vitro fertilization (IVF) can produce embryos for intrauterine implantation. This system may represent a novel IVF approach to give genetically related children to women with ovarian failure or infertility (Bukovsky A., 2006).However producing a genetic related child will not solve the physiological issues that an early menopause is causing in young women. Following the completion of the pregnancy the hormonal rollercoaster that will derive from a similar IVF approach will probably encourage use of HRT for therapeutic purposes.

Bukovsky, A (2006). Oogenesis from human somatic stem cells and role of immune adaptation in premature ovarian failure. Curr Stem Cell Res Ther. Sep;1 (3):289-303.

Donnez J, Squifflet J, Dolmans MM.(2007).Frozen-thawed ovarian tissue retransplants. Semin Reprod Med. 2009 Nov;27(6):472-8.

Heitkemper MM, Chang L. (2009) Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome? Gend Med.;6 Suppl 2:152-67.

Silber SJ. (2009) Fresh ovarian tissue and whole ovary transplantation.Semin Reprod Med. 2009 Nov;27(6):479-85. Epub 2009 Oct 5.