Ovarian Tissue Banking May Restore Fertility
Experimental Procedure May Help Women With Cancer-Related Infertility
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
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
"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
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
"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
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