New Techniques Might Let Cancer Patients Have Kids

By Alissa Dos SantosThe Daily Northwestern

Female cancer patients at risk of infertility from chemotherapy and radiation might still be able to have children.

Northwestern’s Center for Reproductive Research is heading a program that aims to extract ovary tissue or eggs from patients, Dr. Teresa Woodruff said. This would allow the patients to have children later without fertilizing an egg immediately.

“In the last 10 years, there has been an enormous rise in cancer survivors,” said Woodruff, associate director of NU’s Robert H. Lurie Comprehensive Cancer Center and executive director of the Institute for Women’s Health Research at NU’s Feinberg School of Medicine.

With the success of cancer treatment come new issues, such as fertility, she said. During radiation and chemotherapy, eggs can be damaged.

“For men, like Lance Armstrong, you better go bank your sperm,” Woodruff said.

Unlike men, whose sperm production might recover after cancer treatment, the loss of a woman’s eggs is permanent, according to the American Society for Reproductive Medicine.

Woodruff’s goal is to preserve ovarian tissue in order to extract and mature eggs from this tissue in the laboratory. When this technology is fully developed, it might be possible to initiate pregnancies after cancer treatment is over and the patient has recovered.

“The key in this research is taking the early stage follicles and being able to grow them in a Petri dish to a point where they can be fertilized,” said Dr. Laxmi Kondapalli, who works at the Institute for Women’s Health Research at NU. The mature eggs can then be fertilized through standard in-vitro fertilization.

This research also can be applied to women who are not cancer patients, Woodruff said.

But that raises important ethical questions, said Laurie Zoloth, director of the Center for Bioethics, Science and Society and a professor of medical ethics and humanities at NU.

“If we approve this technology, would we also approve this for women who want to postpone childbearing?” Zoloth asked. “Under what circumstances do we manipulate nature?”

The research team had success with a live birth of mice in 2005 and is waiting to perfect the primate model, Kondapalli said.

The research has been a collaborative effort between schools at NU, said Woodruff, who has been working with NU chemical and biomedical engineer Lonnie Shea.

A newly diagnosed female cancer patient now has three options, Kondapalli said. Besides emergency in vitro fertilization, patients can choose from two experimental procedures: egg freezing and ovarian tissue freezing. Egg freezing involves collecting eggs as for in vitro fertilization, Kondapalli said, but then freezing the eggs before they are fertilized.

Ovarian tissue freezing involves an outpatient surgical procedure called a laparoscopy, which takes 20 minutes, Woodruff said.

In the ovarian tissue freezing process, 80 percent of the tissue is preserved for the patient’s use when technology is developed, and 20 percent is donated to the research program, said Kondapalli. So far, two women have donated their ovaries for research.

The team of NU physicians and scientists was the first to name this interdiscipline “oncofertility,” a term now used to refer to the impact of cancer treatment on fertility, Woodruff said.

“A big problem is getting the word out,” said Kondapalli, who is developing a cooperative for fertility preservation among hospitals across the country.

The research will allow female cancer patients to have options available to them when they are faced with a cancer diagnosis, Kondapalli said.

“All of these things are compounded when you are newly diagnosed with cancer,” Woodruff said. “You weren’t sick yesterday, you’re sick today.”

Reach Alissa Dos Santos at [email protected]