Embryo From Younger Sister’s Egg Implanted in Woman

Over the years, the young woman said softly, she had given her sister many presents--clothing, jewelry. But never before “a gift of life.”

Her older sister is infertile. But now, after an in vitro fertilization procedure that used the younger sister’s ovarian eggs, the older woman is in her third month of pregnancy. And both sisters are ecstatic.

Not only is this pregnancy a personal triumph for the Mission Viejo women, but according to several fertility experts around the country, it may have made medical history.

For this appears to be the first successful in vitro fertilization in the United States that used a frozen embryo from a sister’s donated egg, said Dr. Lawrence B. Werlin, director of Fertility Services at Hoag Hospital in Newport Beach, who worked to achieve the pregnancy.

In vitro fertilization--a technique in which the egg is fertilized in a laboratory dish, then placed in the womb--began in 1978 at a clinic in Bourn, England. It has been available in the United States since 1981.

Since then, 3,000 to 5,000 children--known as “test tube babies”--have been born in this country, according to the American Fertility Society in Birmingham, Ala. Sister-to-sister egg donations for IVF are a relatively recent development. Doctors have been freezing--or “cryo-preserving”--embryos, then thawing them for implantation, for only the past 2 1/2 years, Werlin said.

His decision to combine a sister-to-sister egg transfer with the freezing procedure happened almost by accident.

Werlin began working with the two sisters last winter after he had determined that the older one had experienced “premature ovarian failure,” that is, her ovaries no longer produced eggs.

But Werlin told the older woman that she still could have a baby through in vitro fertilization and that she could ask her younger sister to contribute the eggs.

The younger woman readily agreed. She said her older sister had been “crying every day” because she was afraid she couldn’t have children. “I wanted her to stop crying,” said the younger woman.

The sisters, ages 27 and 37, and the older sister’s 41-year-old husband all agreed to discuss their unusual experience if their names were not used. The younger sister is single, and all three said they feared that when the younger woman marries, her husband might be offended that her eggs were fertilized by another man.

The egg retrieval procedure began in February. Over a 21-day period, the younger sister received injections of fertility drugs to stimulate her ovaries to release multiple eggs. Then, guided by an ultrasound scan of her uterus, Werlin used a needle to remove 38 oocytes, or eggs, from her. Then, using sperm from the older sister’s husband, Werlin and his associates fertilized 24 eggs in the laboratory. Several days later, he transferred four of these “pre-embryos” to her womb and waited to see if pregnancy would occur.

It did not. When the blood test came back negative, the older sister cried, Werlin said, adding, “We were crushed, as well.”

But the fertility specialist tried again, this time using several of the two dozen embryos he had frozen and saved in his laboratory. “I felt that we had 20 frozen embryos here, and we wanted to try to give her the best chance we could,” Werlin said.

On March 8, he removed four embryos from storage and thawed them for several hours. Then, as his patient’s husband watched, Werlin made a small incision in her abdomen. Using a small catheter, the obstetrician deposited the tiny embryos at the end of her right and left Fallopian tubes.

Twelve days later, the blood test was positive. Both sisters screamed with joy.

On March 27, Werlin said, an ultrasound exam “documented a gestational sac in her uterine cavity.” And by mid-May, another ultrasound showed an 11 1/2-week-old fetus moving inside the sac.

Still, the expectant parents decided to wait awhile before telling the rest of their large family about the pregnancy. They wanted to be sure it would last, they said. But after a month, they celebrated.

Devout Buddhists, they said prayers and held a traditional feast of roast pig. Recently, her petite figure expanding rapidly, the older sister selected maternity clothes.

She and her husband have never been so happy, they said. They can’t thank the younger sister enough. “This is wonderful,” the husband said. “This is a gift for life.”

The younger sister agreed. “This is a great experience,” she said. “I have given her jewelry and clothes, but this is something money cannot buy.”