Fertility Preservation for Cancer Patients

There are many young women today who are cancer survivors, but their remarkable cures have cost most of them their fertility. Bone marrow transplantations, modern radiation treatment, and aggressive chemotherapy permanently cures up to 90% of cancers in young women today, but their eggs and ovaries are either completely or partially destroyed by these treatments.

For many years (since 1994), scientists have been hoping that the ovaries of such patients could be removed and frozen before such cancer therapy destroys them, so that maybe in the future these cryopreserved ovaries could be transplanted back to the patients, and thus restore their fertility. Dr. Sherman Silber of St. Louis, Missouri , demonstrates that this dream is now a robust reality.

Dr. Silber demonstrates this procedure for preserving fertility in a 31 year old woman who first saw him as a cancer patient at age 19. She was a 19 year old girl then about to undergo treatment for a severe case of Hodgkin's’ lymphoma which her doctors told her would render her permanently sterile, and if she were cured of cancer, she would nonetheless become permanently menopausal, and never be able to have children. Dr. Silber warned her in 1997 that he could not predict at that time if it would indeed allow her to have children in the future, but it was her only chance, and at the young age of 19, she decided to take it, and it worked!

During the three years after her ovary was frozen by Dr. Silber, she wound up having several recurrences of her cancer, requiring two bone marrow transplants and many rounds of radiation and chemotherapy. But eventually she was cured and indeed, eleven years later she got married at age 31. Although she was prematurely menopausal, she still dreamed of having children of her own, which her cancer doctors had warned her, could never happen. Yet after she received a transplant of her ovarian tissue (which had been frozen 12 years earlier), she conceived a healthy child. Over 60 such young cancer patients have subsequently undergone freezing of eggs or ovarian tissue at the Infertility Center of St. Louis. Now it appears that their dreams will indeed come true.

Meanwhile, Dr. Silber from 2003 until 2009 had performed a remarkable series of nine ovary transplants between very rare identical twin sisters who were discordant for premature ovarian failure (which means that one sister had gone into menopause early in life and the other identical twin sister was quite fertile). This unusual series of transplants produced 12 pregnancies in the eight otherwise sterile recipients who had Fallopian tubes, and eight healthy births (4 miscarriages). The technical innovations he had the opportunity to develop in such a series, clarified how the ovarian tissue needs to be frozen, thawed, and indeed transplanted, to get optimal results with cancer patients.