Tissue transplants can help women have babies after they have received treatment for ovarian cancer.
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Receiving treatment for cancer can render a woman infertile.
Cancer patients undergo painful and powerful chemotherapy treatments that can impair a woman’s fertility. However, scientists have raised concerns that the tissue that was removed and then transplanted back could have cancer cells and this could bring the cancer back. This kicks the remaining ovary back into gear, restarting the process of ovulation in about four to five months.
Danish doctors offered the procedure to 32 women whose cancer therapy had left them at risk of infertility. “This technique still needs to be further validated, but the results are reassuring”, Dr. Yacoub Khalaf, director of the Assisted Conception Unit at Guy’s Hospital in London, who is also working to refine the procedure, said in a press release. “This may reflect the fact that the numbers are still relatively small but may also indicate that cancer survivors are a heterogeneous group of patients in whom more factors than normal influence the outcome”, the researchers wrote. As yet, it is uncertain whether it would be funded by the NHS, so undergoing this procedure could prove expensive.
According to Dr. Avner Hershlag from New York’s North Shore University Hospital, the study and research is “exciting” as the ovary transplantation procedure has been made possible through advances in reproductive medicine and treatment of cancer. “It should prompt people in the United Kingdom to provide the service more frequently”. Ten were successful and had at least one child.
Prof Adam Balen, spokesman for the Royal College of Obstetricians and Gynaecologists, agreed the study added further reassurance that ovarian transplantation carried little risk of containing cells that might cause cancer to return.
They compared the cancer recurrence rates of women who’d had transplants with women who had not had transplants, although they did not have accurate data for the women who hadn’t had transplants – they relied on figures of reported deaths, which may have been different from cancers. The research paper does not say how this was measured.
Among the 32 women in the study who wanted children, 10 became pregnant and gave birth.
There were also three abortions, including one miscarriage at gestational week 19.
Ten women became pregnant but miscarried or terminated their pregnancies.
Overall, 14 children were born to the 41 women – eight naturally and six through IVF. Of the three relapses that occurred, two were of breast cancer at the site of the original tumors, and one was of Ewing’s sarcoma. The proportion of women with cancer recurrence (7%) was the same among the women who’d had transplants as the estimated proportion among women who didn’t have transplants. Average age of the first transplant was 33. For 3 of the women, more than 10 years elapsed between removal and transplant; for 6 patients it was more than 8 years, and for 15 patients it was more than 5 years.
The researchers stress the importance of following up women after such transplants.
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The researchers say their findings show ovarian tissue transplants are a “valid method for fertility restoration” and that, “The level of safety appears high, with no relapse [of cancer] due to transplantation of ovarian tissue recorded to date”.
