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There are many young women today who are cancer survivors, but their remarkable cures have cost most of them their fertility. Bone marrow transplantations, modern radiation treatment, and aggressive chemotherapy permanently cures up to 90% of cancers in young women today, but their eggs and ovaries are either completely or partially destroyed by these treatments.
Preparing ovary tissue for freezing.
For many years (since 1994), scientists have been hoping that the ovaries of such patients could be removed and frozen before such cancer therapy destroys them, so that maybe in the future these cryopreserved ovaries could be transplanted back to the patients, and thus restore their fertility. Dr. Sherman Silber of St. Louis, Missouri [see video], demonstrates that this dream is now a robust reality.
Dr. Silber demonstrates this procedure for preserving fertility [see video] in a 31 year old woman who first saw him as a cancer patient at age 19. She was a 19 year old girl then about to undergo treatment for a severe case of Hodgkins’ lymphoma which her doctors told her would render her permanently sterile, and if she were cured of cancer, she would nonetheless become permanently menopausal, and never be able to have children. Dr. Silber warned her in 1998 that he could not predict at that time if it would indeed allow her to have children in the future, but it was her only chance, and at the young age of 19, she decided to take it, and it worked! Click here to hear Dr. Silber discuss this case on National Public Radio (NPR).
During the three years after her ovary was frozen by Dr. Silber, she wound up having several recurrences of her cancer, requiring two bone marrow transplants and many rounds of radiation and chemotherapy. But eventually she was cured and indeed, eleven years later she got married at age 31. Although she was prematurely menopausal, she still dreamed of having children of her own, which her cancer doctors had warned her, could never happen.
Meanwhile, Dr. Silber from 2003 until 2009 had performed a remarkable series of ovary transplants between very rare identical twin sisters who were discordant for premature ovarian failure (which means that one sister had gone into menopause early in life and the other identical twin sister was quite fertile). This unusual series of transplants produced 12 pregnancies in the eight recipients who had Fallopian tubes, and eight healthy births (4 miscarriages). The technical innovations he had the opportunity to develop in such a series, clarified how the ovarian tissue needs to be frozen, thawed, and indeed transplanted, to get optimal results with cancer patients.
Transplantation of frozen ovarian tissue.
Next he performed transplantation of frozen ovarian tissue in menopausal patients who had been cured of their cancer, but had frozen their ovary tissue prior to their sterilizing cancer treatment,and achieved healthy pregnancies. One has already given birth. The technical video [see video] shows this entire technique, including patient interviews. It demonstrates that preserving fertility in cancer patients by freezing their ovarian tissue is now a reality.
Melissa Durant says the one positive about her cancer diagnosis is, "I don't have a biological clock anymore… so when I'm ready to have kids, it's not going to be a problem."
The 31 year old cancer survivor told us, “You know, I feel so fortunate that I had cancer. My girlfriends in their 30’s are all worried about their biological clock, but I have a 19 year old ovary, and am, ironically even more fertile than they are.” Therefore this technique not only preserves the fertility of cancer patients, but also can protect non-cancer patients from the otherwise devastating effect of their biological clock.
It is now officially recommended by the Cancer Society that all young men and women should be counseled on how to preserve their fertility before undergoing cancer treatment, as it is not necessary any longer for them to remain sterile as a result of their cancer therapy.
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TV/Radio News Coverage
Print/Web News Coverage
"A Fertility First: Human Egg Cells Grow Up in Lab" Wired.com, July 14, 2009
"Top 10 Medical Stories of 2008" ABC News, December 24, 2008
"Ovary-Transplant Birth" The Independent, November 16, 2008
"Local doctor pioneers ovary transplants" St. Louis Post-Dispatch, February 12, 2007
Technical Videos of Fertility Preservation for Cancer Patients
Amy Tucker talks to her friends in their 30s about their biological clocks but she has a 19 year old ovary.
Amy reflects with Dr. Silber about why she feels fortunate she had cancer.
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