Cancer is a fairly common disease nowadays. It can occur in childbearing-aged women and cause significant damage to their reproductive organs.
Chemotherapy and radiotherapy treatments can cause ovarian function failures, increasing the possibility of temporary or permanent infertility. The damage depends on the treatment and aggressiveness of the lesion.
Due to a series of new techniques, women of reproductive age, who are undergoing cancer treatment, can preserve their fertility. Eggs can be extracted and vitrified or the ovarian tissue can be cryopreserved before the cancer treatment starts. These gametes can, subsequently, be used in an assisted reproduction treatment.
Ovarian tissue transplant is a new technique, which involves the removal and freezing of a part of the ovarian tissue for its subsequent re-implantation in the patient.
This technique relies on the fact that follicles, which contain oocytes are on the outside of the ovary. This way, the tissue can be sutured to the recipient’s marrow as if it were a piece of skin. The production of ovarian hormones is regained and, in consequence, the woman is able to ovulate and conceive a child either naturally or through IVF.
The tissue recipient can be the same patient the tissue was extracted from (auto transplant) or another woman. In the last case, doctors should pay close attention to the immunological compatibility between the two women.
Several children have been born thanks to this technique. However, there are several factors that determine the success of the technique. These include:
- Accessibility to the affected area.
- Environmental factors, such as temperature.
- Space for follicular growth.
- Peritoneal fluid.
- Hormonal milieu.
According to a study published in the American magazine “Fertility and Sterility”, and conducted by researchers at the University of Kansas, several transplants have to be performed for this technique to be successful.
This study has shown that, freezing removed ovarian tissues may result in follicular loss. However, hormone levels and follicular development indicated that ovarian function returns between 12 and 20 weeks after the transplant. A second attempt, made in three patients, showed a faster return of the ovarian function, which lasted between 15 and 36 months. High levels of progesterone and other symptoms were indicatives of a spontaneous ovulation.