GEORGE NEWS - Women who become infertile because of childhood (pre-pubertal) cancer treatment may soon have the option of preserving their fertility through a new technique in which ovarian tissue is frozen for later use.
The technique can also be an aid for women who are diagnosed with a hormone-sensitive malignancy where fertility treatment would promote its growth.
Camilla Janke, an embryologist who forms part of the visiting team of experts at the newly launched George Fertility Clinic, explains that women are born with their complete life-time ovarian reserve with the eggs stored in the cortex (outer layer) of their ovaries.
With the new technique, a slice of the ovarian cortex is preserved and not only the patient's eggs.
"Oncology fertility has become a field of research because many more people survive cancer therapy these days. Eggs (or sperm in the case of a male cancer patient) must be harvested before cancer treatment starts as most of these treatments damage the reproductive tissues, and can render a person infertile," says Janke.
During fertility treatment, the woman's ovaries are hyper-stimulated to promote multiple follicular growth, and not just one as is usual during the monthly menstrual cycle. The eggs are harvested and either frozen or fertilised in a laboratory to be transplanted into the uterus after a few days. Both eggs and sperm can be frozen to preserve fertility and can be stored indefinitely.
Janke says it would be unethical in the case of a young girl to do hyper-stimulation of the ovaries before puberty for egg harvesting, and in the case of adult women with hormone-sensitive cancers, it would be unwise, so the research in ovarian tissue preservation pushes to improve the quality of the lives of this group of patients.
When a woman who has had cancer therapy reaches an age where she wants children, her ovarian tissue (cortex) with the egg stores can be transplanted back on to her ovaries and the cortex starts to regenerate.
A lot of overseas research has been done to fine-tune the method and the success rate of implantation of this frozen tissue and restoration of endocrine ovarian function has proven to be high. Between 80% to 90% of patients get their ovarian function back.
"Ovarian preservation is expensive, but medical aids are increasingly coming into play with fertility treatment and we hope they could in future perhaps start assisting prospective women with this treatment and various other fertility preservation options."
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