Transplanted
Ovarian Strips Result in Fertility Following Chemotherapy
According to a recent article published in The Lancet, the
cryopreservation of strips of ovarian tissue and subsequent
implantation into the abdomen of a female patient resulted
in fertility following treatment for breast cancer.1
Chemotherapy is a common treatment option for patients with
various stages of breast cancer. Unfortunately, chemotherapy
may render a woman infertile due to the effects of the chemotherapy
agents on the ovaries. Pre-menopausal women who are diagnosed
with breast cancer and wish to have children in the future
may be devastated by the fact that they may become infertile
from treatment. Researchers have been evaluating ways in which
to preserve fertility in premenopausal women who are to receive
chemotherapy while maintaining the effectiveness of treatment.
One area of active investigation surrounding fertility issues
is the cryopreservation (freezing at very low temperatures)
of eggs or strips of ovarian tissue that are involved in the
maturation and release of eggs. The strips of ovarian tissue
may then be transplanted back into the patient’s body.
One previous clinical study evaluated the feasibility of the
transplantation of strips of ovarian tissue into the forearm
of patients who were undergoing pelvic radiation or the surgical
removal of their ovaries.2 The transplantation resulted in
successful endocrine (hormonal) function and subsequent release
of eggs from the ovarian strips, leading to the potential
of future pregnancy.
Researchers from Cornell University recently conducted a
clinical study involving a woman who had been diagnosed with
breast cancer at the age of 30. The patient was to undergo
high-dose chemotherapy, including the agent cyclophosphamide
which is associated with a high rate of infertility. Researchers
removed ovarian tissue strips from the patient prior to therapy
and cryopreserved them for 6 years. After 6 years, the tissue
was implanted into the patient’s abdomen. Normal follicle
(egg) development and estrogen production occurred following
transplantation. Researchers were able to retrieve and fertilize
one of the eggs with the sperm from the patient’s husband.
The researchers concluded that long-term cryopreservation
and transplantation of tissue strips from ovaries may ultimately
lead to normal hormone and egg production, with the possibility
of child-bearing capabilities in women who are treated with
chemotherapy. Premenopausal women who are to undergo treatment
with chemotherapy that is highly associated with infertility
may wish to speak with their physician about cryopreservation
or the participation in a clinical trial further evaluating
fertility issues.
References:
1. Oktay K, Buyuk E, Veeck L, et al. Embryo Development after
Heterotopic Transplantation of Cryopreserved Ovarian Tissue.
The Lancet. 2004;363:837-840.
2. Journal of the American Medical Association, Vol 286,
No 12, pp 1490-1493, 2001.
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