Options for Fertility Preservation for Cancer Patients

Some new fertility preservation option are on the horizon, but today the most realistic option for most women is egg or embryo freezing. An article in MedPage Today outlines some interesting options for very young women and girls needing to preserve their fertility because of cancer chemotherapy.

In June, researchers reported the first live birth from a young girl whose ovarian tissue was frozen prior to undergoing disease therapy, and then had an ovarian graft as an adult. After this procedure, she had a spontaneous pregnancy and a healthy delivery. Here is what has happened since and what to expect in this field down the road.

Despite this one success story, fertility preservation for young girls, especially those who are premenarcheal (yet to begin menstruation), remains a highly investigational procedure. But it does add to the growing field of “onco-fertility,” or the preservation of reproductive function for women undergoing treatment for cancer or other diseases.

“With a girl who’s pre-pubertal, [removing ovarian tissue] is going to be fairly new because most of the people who have treatment for cancer are adults,” said Owen Davis, MD, president of the American Society for Reproductive Medicine (ASRM).

Davis said that ideally, the most non-invasive choice for preserving reproductive function is for a woman to go through a cycle of in vitro fertilization (IVF) and freeze her eggs or her embryos if she has a partner. But that time-intensive procedure may take up to 6 weeks. For women who do not have time and must begin their disease therapy immediately or girls who have yet to reach sexual maturity, removing fragments of ovarian tissue may be their only option in order to restore fertility in the future.

However, there may soon be other options on the horizon for older girls who have gone through puberty, but are premenarcheal. Davis and his colleagues at Cornell University published a paper several years ago on a 12-13 year old girl who actually underwent a successful IVF cycle prior to receiving chemotherapy.

“There’s not going to be a whole lot of people who are candidates for that [procedure], but at least we know it’s another thing on the table other than taking someone’s ovary out,” said Davis.

With adult women cancer patients, the most sensible option remains egg or embryo freezing.

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