Over the past decades, advances in fertility, such as in vitro fertilization, also increased reproductive options for female cancer patients. Prior tobeginning chemotherapy and radiation, patients can now freeze down their eggs or embryos to be used after beating the cancer. Unfortunately, these options are not available to everyone. Both egg and embryo cryopreservation require a woman to undergo hormone therapy to cause egg release, which can take two to three weeks. In addition, the same hormones that cause egg release also stimulate many breast cancers. Thus, women needing urgent cancer treatments and those with hormone-sensitive cancers are not eligible for egg and embryo cryopreservation.
One of the newest techniques in fertility preservation can preserve the fertility of many women not able to participate in hormone therapy. This method,called ovarian tissue cryopreservation (OTC), involves the removal of the entire ovary, cryoprotection and freezing, and then reimplantation after a woman in cancer-free and ready to have children. This process requires a short outpatient surgery where physicians make a small incision in the abdomen and use modern surgical techniques to remove the ovary with the aid of a miniature camera. The outer layer of the ovary, which contains
maturing eggs, is then sectioned into thin pieces and frozen down to very low temperatures (colder than negative 300ºF). Once the woman successfully beats her cancer with chemotherapy and radiation, these ovarian tissue sections are then reimplanted during a second procedure.
So who can participate in ovarian tissue cryoprotection? Any patient with a localized cancer outside of the pelvis can be a candidate for OTC. Women with blood-born cancers, such as leukemia and lymphoma, and those with ovarian or uterine cancers are not candidates for fear that reintroducing ovarian tissue will also reintroduce the cancer to a woman in remission. In contrast to previous methods, even young children are eligible for this fertility preservation technique. Imagine a 6 month-old girl going through OTC today. In 2040 she will still be thanking her parents and her oncologists for giving her the dual gifts of cancer remission and fertility.