Fertility Option After Cancer Treatment – Ovarian Tissue Transplant
The development of better cancer treatments has resulted in much improved survival rates for cancer patients, which in turn, has led to many new options and concerns. One of the many concerns for young female cancer patients is the high risk of premature ovarian failure as a result of the life saving cancer treatments. The risk of ovarian failure varies depending on many factors:
•The patient’s age
•Area or field of irradiation
Additionally, the type of chemotherapy used plays a huge role, with the group called alkylating agents posing the greatest risk. This group includes:
•Busulfan
•Chlorambucil
•Cyclophosphamide
•Ifosfamide
•Nitrosoureas
•Melphalan
•Procarbazine
Bone marrow transplantation is thought to be most responsible for ovarian failure with 80% of patients experiencing premature failure.
New Treatment Therapies
Until very recently, fertility treatment centers could offer those patients very few options. Today, one of the most exciting and promising treatment options is the cryopreservation of ovarian tissue as a method of preserving fertility. This treatment option is best for patients too young or are otherwise not a candidate for egg or embryo banking.
What is Cryopreservation of Ovarian Tissue?
Cryopreservataion of ovarian tissue is performed before radiation or chemotherapy treatments and does not require ovarian stimulation. Performed at a fertility treatment center or at an oncofertility center, an ovary is removed from the patient and then frozen. The outpatient laparoscopic procedure takes under an hour, is simple, done under general anesthesia and is not especially painful. Recovery time is minimal and patients can begin cancer treatments in a few short days after the procedure.
Usually within 5 years, after the patient is cleared of cancer, the ovarian tissue is then grafted back onto the patient’s fallopian tubes, and in many cases, restores fertility.
Areas of Concern
Patients should make sure that their physician is very familiar with medical oncology, histopathology and reproductive endocrinology. Although no cancer recurrance from ovarian grafts has been reported has been reported yet to date, it is still a concern. Not every patient is a candidate for the procedure and type of cancer plays a critical role in whether or not this therapy is a suitable option. Of particular concern is breast cancer, as this cancer metastasizes haematogenously.
A thorough evaluation of the tissue must be made to rule out any metastasis. Additionally, a physician may find the procedure is not an option for young breast cancer patients as the patient may be harboring certain gene mutations which may also harbor a co-existing primary ovarian cancer.
The occurrence of ovarian cancer in women under the age of 35 is rare, but it is still a risk that should be considered. Patients with endometrial cancer are also not considered candidates. As promising as the treatment may be, not every treatment is right for every patient. Cryopreservataion of ovarian tissue is still a very new procedure and any concerns should be discussed with your fertility treatment center reproductive endocrinologist.

