Autologous ovarian orthotopic transplantation is a new technique consisting of the extraction and freezing of a section of the ovarian tissue to be reimplanted afterwards in the patient. The female reproductive system is kept intact so that she is able to get pregnant.
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This procedure is used in women of childbearing age diagnosed with cancer desiring to be on motherhood despite the toughness of the chemotherapy or radiotherpay treatment they are undergoing.
Cancer, on its own, does not affect fertility. Conversely, it is both chemotherapy and radiotherapy what damages the ovaries. It is probable that after the disease is overcome, natural ovarian stimulation is not recovered. In such case, the eggs formed do not meet the standards. This prevents fertilisation or embryo implantation to occur.
Once the disease is overcome, waiting a few months is recommended so that fertility can be regained. If after a year menstruation is lacking and cancer chek-ups allow for it, a treatment for autotransplantation of ovarian tissue may start.
The ovarian tissue is thawed to be reinstated in the corresponding ovary. Once the tissue is transplanted, the ovary resumes hormone production and therefore ovulation is reinstated.
With regard to the disadvantages and complications related to the use of this technique, the frozen tissue may contain cancer cells if the ovarian tissue was frozen after the cancer diagnose. It can lead to the reappearance of the tumor.
Nevertheless, the tissue fragments to be biopsied are small and are also evaluated in order to rule out the presence of tumor cells. In case of doubt, the tissue is not recovered.
Pregnancies through autotransplantation have been accomplished either by assisted reproduction techniques or unprotected sexual encounters.
To ensure women with cancer can have the possibility of preserving their fertility to get pregnant after they overcome the disease, the role of the oncologist is essential.
Oncologists must be aware of the situation and they ought to explain the patient the spectrum of alternatives and options she has at her disposal in case she wishes to be a mother.
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