New Treatment May Help Women Maintain Fertility After Cancer

Nikki Llorin

Jan. 9, 2009 – An experimental procedure that preserves ovarian tissue prior to radiation or chemotherapy may help women become pregnant after cancer.

Siteman Cancer Center member Emily Jungheim, MD, a reproductive endocrinologist at Barnes-Jewish Hospital and Washington University School of Medicine, helps expand the reproductive options of cancer patients. She is one of several researchers in the nation working on a newer procedure called ovarian tissue cryopreservation.

Lifesaving cancer treatments can interfere with a person’s fertility by damaging reproductive organs that produce eggs or sperm. While men can bank their sperm for future use, women may have to use donor eggs or adopt so they can have children. “Men have always had better options, but for women, the technology has lagged behind,” Jungheim says.

Currently, standard methods of fertility preservation include in vitro fertilization (IVF) with embryo banking. It is expensive, requires a partner or donor sperm and may delay cancer treatment. Another option is an experimental technique called oocyte (egg) banking. While it does not require sperm, it is also expensive and may delay treatment.

Ovarian tissue cryopreservation is performed before cancer treatment begins. Tissue from the ovaries is removed, divided into small strips and frozen for future use. When a woman is ready to get pregnant, ovarian tissue can be placed back into the pelvis to grow and reproduce eggs.

Researchers are also working on techniques to isolate and fertilize oocytes from the frozen ovarian tissue so that embryos can be placed back into a patient later. This would eliminate the possibility of placing tissue with cancer cells back into the body, and it would also allow patients to use gestational carriers if they need a hysterectomy or if they cannot carry a child as a result of their cancer.

“Freezing ovarian tissue may be better because it can produce hundreds of eggs,” Jungheim says. “Compared to the high expense and limited number of tries involved in egg banking or IVF, this technique may offer more oocytes and therefore more tries to get pregnant. It can also be done quickly for patients who cannot delay their cancer treatment.”

There have only been a handful of successful pregnancies so far using ovarian tissue cryopreservation. Jungheim hopes more women will consider donating ovarian tissue to keep research efforts going so it becomes routine treatment in the future.

Jungheim’s interest in the field is fueled in part by personal experience. She’s married to Siteman medical oncologist Ken Carson, MD, who was diagnosed with testicular cancer at age 19. They met during their medical residency training. As a couple, they have thought about how his cancer treatment would affect his fertility and their chances of having a biological child. “I was worried at first, but I was reassured by the fact that Ken had banked sperm,” Jungheim says. “I knew that we would always have the option of fertility treatments if we weren’t successful on our own.”

Fortunately for Jungheim and Carson, they did conceive on their own. Today they have a biological daughter.

Last year, Barnes-Jewish Hospital and Washington University joined a national collaboration of more than 30 fertility centers across the nation – led by Northwestern University in Chicago – that focus on fertility issues related to cancer.