For the first time ever in Australia, a woman whose chemotherapy rendered her infertile has fallen pregnant using ovarian tissue taken from her body before her cancer treatment, a new study reports.
Chemotherapy commonly kills the eggs in a woman's ovaries but the radical new technique, which has only been successful in 20 cases world wide, offers new hope to women who hope to conceive after cancer treatment.
In the Australian case described in the Medical Journal of Australia, the woman in question underwent an operation at age 37, just before her chemotherapy for breast cancer began.
Doctors collected a small sample of tissue from the surface of the ovary and froze it.
"Even though it's a small sample, there could be tens of thousands of eggs in it," said Professor Gabor Kovacs, International Medical Director at Monash IVF.
After the woman's chemotherapy was completed at age 43, Dr Lynn Burmeister and Professor Kovacs implanted the stored sample into her ovary, where the cells were absorbed by the surrounding tissue.
"As soon as she started ovulating again, we did IVF and she is now in her second trimester of pregnancy," he said, but added that it was technically also possibly for a woman to fall pregnant without IVF following the tissue transplant.
"The whole process of storing ovarian tissue is very quick and inexpensive. I can see a person today, take the tissue tomorrow and they start chemotherapy on Wednesday," he said.
Professor Kovacs said the process may not work if there were not enough eggs in the tissue sample taken, if the eggs did not survive the freezing process or if blood flow to the implanted ovarian tissue was not reestablished after transplantation.
Despite the ease of the procedure, Professor Kovacs said he would not recommend it to women unless it was medically required.
"Some people have said should all young people being doing this, just in case? My answer is definitely not," he said.
"It's early days, it requires multiple operations. To do it for social reasons is not indicated."
Professor Michael Davies, an IVF expert from the Lifecourse and Intergenerational Health Research Group at the University of Adelaide said the breakthrough would provide hope for many couples hoping to conceive after cancer treatment.
"However, with only 20 or so births globally, it's still extremely experimental in its nature. So it's a long way from being a routine treatment at the moment," said Professor Davies, who was not involved in the research.
"As the author states, it's difficult to calculate a success rate from this given that it's the first instance in Australia, and its really only a pregnancy as yet, we're not reporting a live birth of a healthy child. So quite a few of these pregnancies won't carry to term. So it's a sign of the technical feasibility of obtaining a pregnancy, and hopefully the live birth of a healthy child."
It was also important to consider the long-term health consequences of the offspring from the new combination of treatments, he said, but overall the breakthrough indicated the quality of Australian reproductive biology research.
"Clinics and researchers in Australia have consistently been at the forefront of innovation. The first IVF pregnancy in the world was in Melbourne, and they just got pipped getting the first birth," he said.
"The reproductive research in Australia really is among the very best globally."
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