Treatment offers new way to save fertility

NASHVILLE, Tenn. (USA TODAY) -- Younger women diagnosed with cancer take risks in the hope of becoming a mother.

They delay chemotherapy and radiation, gambling that their cancer won't spread during the month they undergo fertility preservation. A new option doesn't require aspiring mothers to have to wait.

Ovarian tissue cryopreservation is so new it has yet to bring a baby into the world. Tissue samples containing stem cells are removed from an ovary, frozen and shipped to a storage bank in Minnesota.

The Center for Reproductive Health at TriStar Centennial Medical Center in Nashville, Tenn., is the only facility in Tennessee offering the treatment. The treatment is funded by a grant from the National Institutes of Health, so it is free to patients.

The stem cells can later be surgically re-implanted or nurtured outside the body to grow an egg for in vitro fertilization. The preservation process is much quicker than the current method, which requires a woman to take hormones to stimulate production so her eggs can be harvested - a process that parallels the menstruation cycle and can delay cancer treatment for up to a month.

The time delay is not the only risk. For some breast cancer patients, the hormones could fuel cancer cell growth in women diagnosed with an estrogen-receptor-positive form of the disease.

Although the new fertility treatment is considered experimental, scientists have documented that the stem cells can grow into an ovum.

An outpatient procedure

Physicians with Northwestern University Feinberg School of Medicine in Chicago, the lead research institution, have performed the procedure on 35 patients.

Tissue samples containing the stem cells are removed with the use of a fiber-optic cable inserted through a small incision in the navel.

"It's a Band-Aid surgery and it's outpatient," said Dr. Jaime Vasquez, medical director of the Nashville reproductive center. "It is a simple laparoscopy."

The tissue sample is taken from one ovary, while the other is left untouched.

"That gives the patient the opportunity of having normal fertility if the chemotherapy or radiation therapy did not kill all the cells in the ovary," he said.

About 50 locations nationwide are offering the treatment as part of a network of cancer specialists and reproductive physicians working with the Oncofertility Consortium on the initiative.

The consortium, which is based at Northwestern, works with the participating doctors and with Reprotech, the company in Minnesota where the samples are stored.

The Oncofertility Consortium is a network for exploring and sharing ways to help cancer patients - both men and women - have a reproductive future. But men have far fewer challenges. Preserving sperm doesn't require surgery.

In 2009, the National Institutes of Health announced that Northwestern scientists Teresa K. Woodruff and Lonnie D. Shea with the help of colleagues had developed a method to advance undeveloped human eggs to near maturity.

Kate Timmerman, program director of the Oncofertility Consortium, said most patients at Northwestern are opting for more traditional preservation methods. But not all cancer patients have that choice.

"Ovarian tissue cryopreservation is an option for prepubertal girls," Timmerman said.

There has also been research in Europe.

"In France, there is one case where a doctor removed ovarian tissue and froze ovarian tissue," Vasquez said. "Then, after culturing the eggs in vitro, (the doctor) helped produce a pregnancy, but it ended in miscarriage."

The stem cells and surrounding tissue are taken from a follicle, a tiny sac within the ovary where the ooycte, the premature ovum or egg, originates.

Future innovations are likely to identify new ways that better perfect making babies from these tissue samples, Vasquez noted.


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