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Ovarian Tissue Banking May Restore Fertility

Experimental Procedure May Help Women With Cancer-Related Infertility
WebMD Health News

March 8, 2004 -- An experimental new procedure that uses stored ovarian tissue may allow women to regain ovarian function and fertility, sometimes lost during cancer therapy.

A new report details the first successful use of cryopreserved (frozen and preserved) ovarian tissue which was re-transplanted to obtain functional ovarian tissue, and human eggs. The egg was successfully fertilized in the lab, to obtain an embryo.

Although the attempt did not result in a successful pregnancy, researchers say the results indicate that long-term banking of ovarian tissue can help women restore normal ovarian function and potentially allow them to become capable of supporting a pregnancy.

The study, conducted by Kutluck Oktay and colleagues at the Center for Reproductive Medicine and Infertility at the New York-Presbyterian Hospital/Weill Cornel Medical Center in New York City, was rushed to release today in advance of its scheduled March 13 print publication in the journal The Lancet.

Ovarian Tissue Transplant Produces Embryo

Experts say the new technique may allow female cancer patients women who undergo premature menopause caused by cancer therapy the same ability men have to preserve their fertility by freezing their sperm for later use.

"The life-saving chemotherapy or radiation treatments used for some kinds of cancers can result in infertility," says Marian Damewood, MD, president of the American Society for Reproductive Medicine, in a news release. "Unfortunately up to now, we have not been able to offer women the same ability to preserve their eggs or ovarian tissue that men have with sperm."

"With Oktay's work we appear to be much closer to the day when a young woman diagnosed with cancer can both survive the cancer, and subsequently have children," says Damewood.

In the study, researchers transplanted cryopreserved ovarian tissue into a 30-year-old breast cancer survivor who donated the tissue before her chemotherapy.

Within three months of re-transplantation, normal ovarian function was restored, as shown by the development of ovarian eggs and estrogen production. Twenty eggs were removed, and eight were suitable for in vitro fertilization with her husband's sperm.

Of those, one egg fertilized normally and developed into an embryo in early stages then was transferred to the woman's uterus.

The woman did not become pregnant, but researchers say the findings show fertility and ovarian function can be preserved in women through long-term ovarian tissue banking.

"Because the probability of pregnancy with one embryo originating from an in vitro matured oocyte [egg] is 6% to 12%, many attempts or simultaneous transfer of multiple embryos might be needed to achieve a pregnancy," write the researchers.

Promising Results, but More Study Needed

In an editorial that accompanies the study, Johan Smitz of the Centre for Reproductive Medicine in Brussels, Belgium, says this research contributes greatly to the understanding of the conditions essential to the establishment of early human life.

But much is still unknown, and further studies are needed to determine the best option for preserving fertility and producing a healthy child in women who have lost their fertility because of premature menopause.

"In light of the current uncertainty about the effectiveness and safety of ovarian cryostorage and grafting, the whole procedure should still be presented as experimental to patients," writes Smitz.

He writes that safety concerns still exist at different levels. Tumors that spread into the ovary are contra-indications for grafting. Although the graft can be studied by sensitive techniques for the detection of cancer cells, it will always be difficult to completely exclude the presence of such cells.

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