For women diagnosed with cancer, chemotherapy and radiotherapy treatment may cause irreversible ovarian damage. IVF prior to treatment is only available to women with a partner or those willing to use donor sperm and is contra indicated for those with hormone sensitive tumours and, additionally, may use up valuable time.
Ovarian tissue transplantation can overcome these problems and now a new freezing and transplantation service, the first in the UK to be fully funded by the NHS, will enable specialists in cancer and blood disorders to refer patients to the Royal Free London, ahead of their treatments, for ovarian tissue freezing down, cryostorage and subsequent implantation to hopefully restore fertility or prevent early menopause.
For pre-pubertal girls and some women with hormone sensitive tumours (for example some types of breast cancer), ovarian tissue freezing is the only way that they can preserve their fertility. Patients who are cured by their chemo/radiotherapy can have cryopreserved ovary tissue recovered, thawed and surgically placed onto the remaining ovary or into the lining of the abdominal cavity.
The treatment involves the patient undergoing keyhole surgery to remove one ovary which can then be processed in the hospital’s laboratory, carefully control rate frozen down and then stored at a liquid nitrogen temperature of -196 ℃. The controlled freezing facilitates a crucial ice nucleation step using a pre programmed series of cooling rates; once frozen safely the tissue is ready for cryo-storage. When needed the ovarian slices may be thawed and transplanted back to the patient post treatment - after months or years.
Around the world there have been well over a hundred successful births as a result of this treatment and many other women have benefitted from restoration of their menstrual cycle after tissue implantation.
Consultant Paul Hardiman (pictured here, above right) said: “We have modelled our protocols on how it is done at the Rigshospitalet, Copenhagen, one of the largest hospitals in Denmark, where they have been freezing human ovarian tissue since 1999. This is a well-established method in Europe, the US and Japan but the UK has lagged behind.”
Natalie Getreu (pictured left) is part of the team that has enabled this new service and she is also looking to increase the knowledge base and is researching methods previously used to reduce ischemia in other transplanted tissues, to the human ova
The Royal Free London has a unique mix of facilities and expertise in tissue freezing and cell therapy including the services of Professors Barry Fuller and Mark Lowdell, and is also a leading kidney and liver transplant centre and the principle UK centre for cell and tissue medicines. The new service will be offered to patients within the London but is planned to expand across the UK soon.