Fertility preservation options for girls
Options for girls
Doctors may use a treatment plan that avoids or reduces doses of chemotherapy that are linked to infertility. For some girls who need radiation therapy, an oophoropexy may be an option.
This is when a surgeon moves one or both ovaries where radiation will not reach them. The surgeon may put them back in place after treatment. However, it is not always possible to prevent damage to the ovaries.
It is important to talk with your daughter’s health care team about the risk of infertility based on treatment plan. You may decide against fertility-preserving techniques with cancer treatments that have a low risk of affecting fertility.
Many girls go through puberty after cancer treatment and have children naturally.
Oocyte (unfertilized egg) freezing
A girl who has gone or is going through puberty can freeze her eggs. This method requires about 2 weeks of fertility drug treatment. The eggs are then collected from the ovaries.
Sometimes, girls need to begin cancer treatment right away. This does not allow time for the 2-week fertility treatment.
Instead, egg collection may occur after only brief fertility treatment or even without it. These eggs will not have fully matured in the ovaries. The eggs must then undergo in vitro maturation. This means that the eggs mature in a laboratory.
Researchers are still learning about in vitro maturation. Success rates are lower than when freezing eggs that matured in the ovaries.
Ovarian tissue freezing followed by transplantation
Freezing eggs is not an option for girls who have not gone through puberty. Freezing ovarian tissue for later transplantation may be an option for these girls. This method is sometimes called ovarian cryopreservation.
It was previously considered experimental. But now this procedure is improving and becoming a more standard option.
It is done as an outpatient laparoscopic surgery. Laparoscopy uses a thin, lighted tube called a laparoscope to remove ovarian tissue. A surgeon inserts the laparoscope through a small cut made in the abdominal wall. The surgery lasts about an hour.
Later, ovarian tissue can be transplanted back to the patient during an outpatient procedure. It can be transplanted to the pelvis or under the skin.
A limited number of experts offer ovarian tissue freezing. For some types of cancer, the doctor may advise against tissue freezing. There may be concern that transplanted tissue could carry cancer cells back into the body. Ask a fertility specialist to help you evaluate this option.