Cancer and its related medical treatment plan can have a major impact on future fertility. More so, for prepubertal girls diagnosed with cancer, these consequences can include irreversible, permanent damage to their reproductive organs and egg loss. With the pediatric survival rate exceeding 80%, it’s reasonable to suspect that most will survive more than 5 years from their initial cancer diagnosis and then go on to becoming adult with desire for reproduction.

Historically, these patients did not have any options to preserve fertility prior to undergoing cancer treatment.  However, in late 2019 the American Society of Reproductive Medicine (ASRM) removed the “experimental label” from ovarian tissue cryopreservation and it is now deemed an acceptable fertility preservation technique. For prepubertal girls, this brings a new wave of hope.

With the leading experience of our physicians and embryology team, Brown Fertility is now the first and only center in Florida offering this surgical fertility sparing procedure. Dr. Samuel E. Brown, Mayo Clinic professor & Medical Director of Brown Fertility, leads the pioneering team with this medical science breakthrough to providing those a second chance to having children later in life.

“We are now able to provide treatment and hope to this group of young females with cancer that was previously blocked from fertility preservation options” – Dr. Brown

What is Ovarian Tissue Cryopreservation?

Ovarian tissue cryopreservation (OTC) is a method of fertility preservation in which the outer layer of an ovary, which contains a large number of eggs, is surgically taken out of the body and cryopreserved, or frozen, for future use.

As of 2017, there have been over 130 live births reported after transplantation of previously cryopreserved and thawed ovarian tissue. This technique has been successful in pediatric cancer patients with a variety of malignant and nonmalignant conditions.

How is OTC different than other types of fertility preservation?

Unlike traditional fertility preservation of egg freezing, where just one cycle can take a few weeks to complete, OTC can be performed on very short notice. Even women who must undergo chemotherapy or radiation almost immediately after a cancer diagnosis may be able to preserve their fertility using this method.  Patient and family will meet with one of our physicians and patient navigator to determine fertility risks, identify available egg or ovarian tissue preservation

options and coordinate team efforts throughout the treatment process. Once OTC is the decided plan of care, the patient and family can prepare to schedule the same-day procedure. Minimal, routine follow-up care is necessary after surgery.

Another advantage to OTC is the number of eggs that can be frozen at once. Traditional egg freezing stimulation produces on average approximately 10 eggs per retrieval attempt. Whereas cryopreservation of ovarian tissue, theoretically can preserve many thousands of ovarian follicles at one time. OTC is an excellent option for prepubertal females and for those who cannot delay cancer treatment in order to undergo traditional ovarian stimulation through IVF. 

How long can ovarian tissue be frozen for?

Human tissue can be stored for many years, research shows over 10+ years, or until the patient is ready to use them to create a family. The OTC process can be technically challenging, and patients and their families should only consider centers with the necessary laboratory and surgical expertise. Our embryologists are the most experienced in the country and offer expertise in handling and preserving ovarian tissue.

“Ovarian tissue cryopreservation starts a new chapter for patients to preserve their future fertility and we are proud to be a part of this family creation process” – Dr. Brown

Ovarian tissue cryopreservation brings a safeguard to fertility in pediatric cancer patients, notably in young prepubertal girls who cannot delay the onset of their treatment. At Brown Fertility, our team is committed to staying on the forefront of advancements in reproductive medicine. We welcome the opportunity to explore all aspects of the fertility preservation process and help guide patients and their families in deciding which option is best for them.

Resources:

https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/fertility_preservation_in_patients_undergoing_gonadotoxic_therapy_or_gonadectomy.pdf

https://ascopost.com/issues/january-25-2020/ovarian-tissue-cryopreservation-to-preserve-fertility-in-pediatric-patients-with-cancer/