Besides breast cancer, a large number of women suffer from other forms of gynecological cancer such as the ovarian cancer, the cervical, while a great number suffer from other malignancies.
Especially concerning breast cancer, 10% of the women are below the age of 44 years, while 2% of the patients are younger than 34 years. Of course, the treatment of these cancers has been significantly improved in recent years, so that the five-year survival rate is in many cases 90%. As a result, many of these women wish to create a family after their recovery.
In accordance with the official guidance of the American Society of Clinical Oncology, all people at a reproductive age who have been diagnosed with some form of cancer, must be informed of the impact of the treatment on their fertility, as well as of the techniques through which they can maintain their reproductive ability after the treatment.
Cryopreservation of oocytes and embryos
Until a few years ago, the oocyte freezing was one experimental method with low success rates. In recent years, however, the method of vitrification enabled us to freeze the oocytes with excellent survival rates, reaching 90-95%.
The oocyte can be kept in the freezer for several years, so that after the woman's recovery and if she wishes to, they can be thawed, fertilized with the sperm of the partner / spouse and transferred into her uterus.
This method is applied with great success in IVF centers in Athens for more than a decade. To do, however, the patient must undergo ovarian stimulation, a process, which lasts 10 to 12 days or proceed with natural cycle without medication.
During stimulation, estrogen levels in blood increase greatly, which is not desirable at all, especially in women with hormone-dependent cancers, such as breast cancer. In these cases, we use another set of drugs, which inhibit the estrogen production but without affecting the growth of the follicles. Worldwide, more than 1400 healthy children were born with this method.
2. Preserving ovarian tissue
In some cases, the ovarian stimulation is not possible. In these cases, therefore, the only way to preserve fertility is the maintenance of the ovarian tissue. Before the beginning of the chemotherapy, the patients undergo laparoscopy during which a part or the whole of the ovary is being removed.
The ovarian cortex, which contains the largest concentration of follicles, is shredded into small particles, which are being frozen in liquid nitrogen. Until now there have been more than 10 ovarian tissue transplants and 20 children were born in this way. This method is still experimental.
Argyrou Marina, PhD
Clinical Embryologist, Embryogenesis