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It is true that cancer is, in the main, a disease of middle age and the elderly. However, younger people, even pre-puberty juveniles, are not completely spared. Hodgkin’s Disease remains the commonest type of cancer in women aged 15 -24 years with excellent survival rates of well over 90%.

When cancer in a girl or young woman occurs, one of the difficult issues to contend with is the effect the treatment will have on that person’s fertility.

Cancer treatment takes the form of chemotherapy, radiotherapy and surgery. Sometimes it is a combination of all three.

All three forms of treatment can have effect on fertility. Moreover, the location of the cancer may very well be away from the reproductive organs but the treatment especially chemotherapy and radiotherapy could have the effect of making it difficult or impossible for the individual to retain fertility.

This is a broad subject and we have no intention of covering it all. We are therefore confining ourselves to recent developments in techniques to preserve fertility for girls treated for cancer.

The older patient

For a woman already at a reproductive age and especially if in a relationship, it has been the norm for years to harvest eggs prior to starting treatment, getting them fertilized and implanting the resulting embryo(s) in the womb once she has the all-clear at a later date.

Preserving Unfertilized Eggs

Until a few short years ago, attempts to preserve unfertilized eggs almost always ended in failure with only a dismal 2% of them being successfully fertilized resulting in a live-birth afterwards. However, relatively recently, better methods of freezing (cryopreservation) unfertilized eggs have been successfully developed.

The story of the development of the new technique is that of man’s ingenuity in overcoming adversity. It was developed in Italy after the 2004 law banning the freezing of fertilized eggs (embryos) in that country.

The new method is still highly specialized and only available in a few centres around the world. To get the gist of the degree of challenge facing fertility experts, this method that is being hailed has a success rate of about 5 -6%! This means, out of a 100 frozen eggs, we can expect 5 or 6 live births. This may look dismal but it is a real scientific leap and from here on, things can only get better.

For the very young

Earlier this year (2007), scientists from Hadassah University Hospital in Jerusalem announced that they had successfully extracted eggs from cancer patients aged between 5 and 10, artificially matured and cryo-preserved them. Of-course it will be a few years before it is known whether the ultimate goal, that of enabling these young cancer survivors to become mothers, is realized. However, even this hope would have been a pipe-dream 2 or 3 years ago.

Preserving Ovarian Tissue

In  September 2004, a Belgian woman Ouarda Touirat became the first ever woman to give birth after frozen ovarian tissue had been implanted back into her body. In fact, freezing of ovarian tissue prior to cancer treatment has been practiced for over a decade now but this was the first such birth.

In 2005, Stephanie Yarber in St. Louis in the United States gave birth to a daughter after she had received ovarian tissue transplant from her twin sister. In her case, she had gone through very early menopause when she developed premature ovarian failure at age 14.

Freezing the whole ovary

Probably the holy grail of fertility preservation for a woman will be the ability to cryo-preserve the whole ovary and implant it back into the body years later. Some have gone further to suggest that this could be the perfect answer for the ambitious woman who wants to pursue her career and start a family later, in her 40 or even 50s. Others have even suggested that the technique could effectively be used to postpone the menopause since the ovary will have been frozen in time and will remain at the age , let’s say the mid-20s, when it was extracted. However, let’s not get ahead of ourselves. At the time of writing this, there is a lot of research in this area in many centres across the world. However, success does not appear to be on the horizon just yet.

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Last update: October 17, 2010

Tamara Touirat was the first ever baby born after  re-implantation of frozen ovarian tissue in 2004

Preserving Fertility after Cancer Treatment