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Emerging Fertility Options

Science is advancing quickly to develop even more fertility preserving options for women diagnosed with cancer or other conditions that threaten their ability to have a baby. Here are two approaches that, while not yet widely available, illustrate where the science is headed and paint an even more optimistic picture of the future of fertility preservation.

Ovarian Tissue Cryopreservation

This technique involves removing all or part of an ovary and freezing a tiny section of its lining. Called the ovarian cortex, this lining holds the follicles containing the oocytes. Sometime later, the cortex can either be surgically reinserted into the patient or nurtured and fertilized in a lab.

A significant aspect of ovarian cortex transplant is that it restores endocrine function. The technique, which has been in use for more than a decade, is not yet widely available and is not currently offered at Michigan Medicine. But it has been successfully used in U.S. hospitals and in leading centers in Europe, Asia and Israel.

About 100 patients have had the microsurgical procedure to transplant cortex tissue back into their bodies. While the risk is believed to be small, there is a chance that cancer could be reintroduced into the body through this procedure. Researchers are currently pursuing another, related option called in vitro follicle maturation that nurtures ovarian cortex tissue outside the body.

In Vitro Follicle Maturation

Michigan Medicine is one of the only centers in the U.S. with researchers in obstetrics/gynecology and biomedical engineering collaborating on a technique called in vitro follicle maturation. In this approach, the follicles from the ovarian cortex are removed and allowed to mature outside the body, attached to a structure made of biomedical materials.

This approach has even more widespread implications for preserving fertility. For example, young girls diagnosed with and treated for cancer before puberty may never be able to have children. But by removing and freezing a section of ovarian tissue before cancer therapy begins, in vitro follicle maturation may be an established option by the time they reach childbearing years.

Much work remains to develop the right materials and process to culture follicles, but researchers believe they are close to identifying the correct environment to make this option possible.