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Cancer survivors keep fertility with new treatment

For younger women diagnosed with cancer, the treatments necessary to treat their disease can also make them infertile. But an experimental procedure is giving those women a second chance, by freezing ovarian tissue before cancer treatment begins. NBC's Dr. Nancy Snyderman reports.

Until very recently, young women who went through cancer treatment often discovered their fertility was a casualty of life-saving therapies. But a new option – the removal and freezing of an ovary prior to chemotherapy and radiation treatments – may be changing all that.

So far, 20 babies have been born worldwide as a result of this new procedure, which is called ovarian tissue cryopreservation, Dr. Nancy Snyderman reported on NBC Nightly News with Brian Williams.

This is good news for the estimated 1 in 46 women under age 40 who are diagnosed with some form of cancer, since chemotherapy and radiation -- the most common treatments -- can destroy a woman’s fertility.

One of the specialists who's been working with the technique is Dr. Kutluk Oktay, a professor of obstetrics and gynecology at New York
Medical College and director of the Institute for Fertility Preservation/Reproductive Specialists of New York.

“Ovarian cryopreservation is a procedure where, when a woman is faced with a medical condition that would affect [her] future fertility, the ovary is removed through a keyhole procedure and it's taken through a specialized process which involves treating the tissue with antifreeze substances and utilizing an automated process to preserve the ovary for future use,” Oktay explained to Snyderman. “If you were a cancer patient 15 years ago, your options in terms of fertility preservation would be close to zip.”

While the option of freezing eggs before treatment has been available for the past several years, that alternative won’t work for those with aggressive cancers or hormone sensitive tumors, Oktay explained.

For egg harvesting and freezing, women need to go through a process in which their ovaries are stimulated with hormones that will spark the production of many eggs in one cycle, Oktay said. Those hormones can make some cancers -- like ovarian or certain forms of breast cancer -- worse.

And some women just can’t hold off on cancer treatments for the three to six weeks the process takes, said Dr. Kyle Orwig, an associate professor at the University of Pittsburgh Medical Center and director of the fertility preservation program at UPMC. Orwig’s institution is also looking at the viability of ovarian cryopreservation. 

How does this new ovary-freezing procedure work?

Doctors remove an ovary and then, once a woman has completed cancer treatment, transplant the tissue back into the abdomen – or even under the skin. Once transplanted, the ovarian tissue will be able to turn its supply of immature eggs into viable ones, Oktay explained.

The procedure takes about 40 minutes and can be done under local anesthesia. As for cost – that all depends on whether the procedure can be done as a part of another surgery.  If it can, the charge would be minimal, Oktay said. Otherwise, it could run anywhere from $6,000 to $10,000.

For Morgan Thompson, 29, it’s enough to know that she might one day be able to have a baby. Thompson was diagnosed with Hodgkin’s lymphoma three years ago and was referred to Oktay when she told doctors she wanted to somehow preserve her fertility.

“It is a very shocking thing to have to deal with at any age,” Thompson told Snyderman. “But at 26, I was not prepared at all. I always knew I wanted to be a mom. In my mind I was going to have twin girls and a little boy. I had everything perfect in my head.

“You want to be told that you have options. You want people to think that you’re going to be here in order to make the decision to even have kids. So a procedure like this is amazing.”

While the new procedure offers women hope, no one knows exactly how risky the procedure is - yet.

It is still surgery, which means it comes with all the risks associated with surgery, Orwig said

The biggest concern, however, is the possibility that doctors might be putting cancer-tainted tissue back into a patient who’s been cured, Orwig added.

In that respect, some cancers are more risky than others.

“A good example would be leukemia,” Orwig said. “It’s a cancer of the blood and blood circulates through all the tissues, including the ovaries. If we put the ovarian tissue back into the patient, there’s a risk that we could be reintroducing the cancer. We don’t have the answer to that yet. We need to be certain that we’re transplanting cancer-free tissue.”

Ultimately, women need to recognize that the procedure is still considered to be experimental, Orwig said.

“I think it’s important that it works - although it’s experimental there are at least 20 live babies so far,” he said. “But there are risks and it’s way too early to remove the experimental tag.”