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Ovarian Transplant: Possible But Will It Preserve Your Fertility?
BACKGROUND: Ovarian tissue transplantation is now an option for women who want to protect their fertility and hormones while they undergo treatment for cancer, including chemotherapy and radiotherapy. Many times this type of rigorous cancer treatment can destroy or damage a woman's ovaries.
THE PROCEDURE: Before a woman receives chemotherapy, surgeons remove one of her ovaries and cut it up into small pieces. The pieces are then frozen in a cryotank. Once a patient is in remission, she can consult with a reproductive specialist about the viability of her frozen ovarian tissue. If the tissue that was preserved remains healthy, the patient undergoes surgery to have the small pieces of tissue implanted. Surgeons sew the pieces onto the remaining ovary, which is now considered the host ovary. It creates a pocket where new eggs can form. "Even small pieces of ovary can produce follicles and can release eggs, which can be fertile and result in pregnancy," Dr. Yalcinkaya, of the Wake Forest University Center for Reproductive Medicine, said. "Unlike other organs such as the heart, brain or kidney, the ovary can function in small fragments."
OUTCOMES: In many cases, women are hoping the transplant results in pregnancy, but that's not the only goal. A lot of times heavy doses of chemotherapy and radiation can put a woman in early menopause. "They want to enjoy their normal menstrual cycle and the female hormones that come with the menstrual cycle after their disease is in remission," Dr. Yalcinkaya explained. Dr. Yalcinkaya says there have been a few dozen cases around the world where ovarian tissue transplants resulted in live births, but he cautions women not to set their hopes and expectations extraordinarily high when it comes to getting pregnant after the transplant.
RISKS: Sometimes after treatment for leukemia and certain types of sarcomas, the tissue contains some cancer cells, and they have the theoretic risk of restarting the disease in the ovary. Dr. Yalcinkaya says the transplant could be an option for women who recover from breast cancer and lymphomas and other types of cancer that do not spread to the ovaries. He urges women who are considering a transplant to meet with their oncologist and a reproductive expert to determine if it's safe for them. Read more.