This is the first such case in the world. French doctors reported that the pregnancy was brought to a happy end in an infertile woman who could not have children after treatment with chemotherapy. Fertilization became possible thanks to the IVM method of freezing the eggs.
Pregnancy after chemotherapy – more and more options
Researchers in France reported that a 34-year-old female patient, who became sterile as a result of chemotherapy treatment for breast cancer, had a baby because doctors had frozen the woman’s immature eggs earlier. After five years, when they were able to thaw them, one of the cells matured in the laboratory was fertilized. The case is reported in the journal “Annals of Oncology”.
Before starting treatment, doctors removed seven immature eggs (oocytes) from a woman’s ovaries and used a technique called in vitro maturation (IVM) to allow them to continue to grow outside the body in the laboratory. The IVM technique is mainly used in patients with polycystic ovary syndrome (PCOS). It brings the best results in women under 35 who have at least 10 antral follicles (from which oocytes are collected). In the case of a patient in France, an ultrasound scan showed that her ovaries had 17 small, fluid-filled sacs containing immature eggs. IVM has already been used in cancer patients, but has not yet resulted in a successful pregnancy.
IVM – a less invasive option
The doctors also proposed to the French patient a second, experimental method – the so-called cryopreservation of ovarian tissue. In this case, the outer layer of the ovary, which contains the immature eggs, is taken out completely and then frozen. This method, which is more invasive and requires the use of hormones, could worsen a woman’s condition. In a French patient, the oocyte collection procedure was performed omitting the stage of hormonal stimulation of the ovaries.
“The technique of preserving by freezing without (hormonal) stimulation works worse, but in this case we really had no choice,” said Prof. Michaël Grynberg from the Antoine Béclère University Hospital near Paris.
Five years after the end of treatment, the cells were thawed. Sperm injection was performed and one embryo was transferred. The woman gave birth to a healthy boy on July 6, 2019.
When treating young cancer patients, fertility protection should always be considered. Vitrification of the egg or embryo after ovarian stimulation is still the best known and most effective option. However, in some patients, ovarian stimulation is not possible because of urgent cancer treatment or some other contraindication. In these situations, ovarian tissue freezing is an option but requires a laparoscopic procedure, and in some diseases there is a risk of malignant cells being reintroduced when the tissue is transplanted back into the patient. IVM allows us to freeze the eggs or embryos in urgent situations or when stimulation of the ovaries would be dangerous for the patient. Moreover, its use is not associated with the risk of cancer recurrence.
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