What is Oncofertility research revealing?

It is critical to remember that every individual experiences cancer, chemotherapy, and radiation uniquely and individually. Cancer is very personalized. The goal of the Oncofertility Consortium is to provide patients with broad options for preserving fertility, but also to consider the circumstances of each individual.

Unfortunately, the options currently available do not fit the needs of all patients. In particular, young women and girls and boys who have not gone through puberty do not have many options for preserving their fertility prior to cancer treatment. In response, the Oncofertility Consortium was created to find new options.

Today, if a young woman cannot postpone cancer treatment, or cannot or does not wish to undergo hormonal stimulation to create embryos or eggs for freezing and storage, her only option is to wait until after cancer treatment to see if her fertility returns. If she doesn’t, she could pursue other options, such as using donor eggs or adoption.

One option that is being investigated by the Oncofertility Consortium would allow a girl or woman to undergo laparoscopic surgery to remove an ovary prior to cancer treatment. The surgery has only a one-to-two day recovery period, which means cancer treatment would not need to be postponed. Also, no hormone treatment is necessary, so this option would be appropriate for young girls who have not yet gone through puberty. Tissue from the removed ovary would be frozen and stored for use at a later date.

After cancer treatment, the tissue could be thawed and transplanted back into the woman. To date, there have been a handful of live births after transplantation of ovarian tissue. However, this approach carries a risk of possibly “reseeding” the cancer from malignant cells in the transplanted tissue.

Another option that is currently under investigation at Northwestern is the isolation of immature eggs, housed within a structure called a follicle, from the thawed ovarian tissue. The immature follicle would be matured in the laboratory until the egg is ready for fertilization using sperm from the woman’s partner or an anonymous donor. Thus far, this technology has been used successfully in mice to produce live, healthy offspring, and is being adapted to humans.

Ovarian tissue removal, freezing, and storage is currently being offered to young girls and women with cancer with the hope that the technology to mature eggs in the lab will be available when they are ready to have a family.

Men who wish to preserve their fertility may produce semen samples and have them frozen using techniques that have been available and successful for many years. However, this option may not be possible for boys who have not yet gone through puberty.

For pubertal boys and for men who cannot produce a sperm sample through conventional methods, there is the option of undergoing sperm extraction (Onco-TESE) or a testes biopsy. In both cases, testicular tissue is removed and sperm is extracted, frozen, and stored for later use in procedures such as artificial insemination, IVF, or intracytoplasmic sperm injection (ICSI).

Click on the links to the right to see more detailed descriptions of each of these options.