Johns Hopkins Gynecology
January 13, 2015
Reproductive endocrinologist Mindy Christianson at the Johns Hopkins Center for Fertility Preservation wants physicians to know that preserving fertility can be part of the plan when treating patients with cancer or other fertility-threatening illnesses.
Oncologists are primarily concerned with treatments that yield the best possible outcomes, and rightly so, says Christianson; but many patients do not see the decisions as so clearcut. They may be looking down the road at other issues, such as their ability to have children, and want answers before deciding on cancer therapy. For this reason, oncologists recognize future fertility as a key survivorship issue for young women. These patients often benefit from consultation with a reproductive endocrinologist to discuss fertility preservation options.
Specialists at the Johns Hopkins Center for Fertility Preservation have seen roughly 500 patients over the last 10 years, with the number of patients increasing greatly during the past three to four years. They emphasize that, in addition to managing how treatments are delivered, there are a number of pretreatment options, including cryopreservation of embryos, oocytes or sperm, particularly for patients who need chemotherapy or other drugs that may damage eggs or sperm.
“Our goal is to see patients facing these decisions within two business days because our evaluations can affect cancer treatment and fertility preservation,” says fertility specialist Lisa Kolp. “For many patients, there may be a window of time in which we can begin treatment to freeze eggs, embryos or ovarian tissue.”
The most commonly implemented fertility preservation methods include embryo and oocyte cryopreservation. Christianson notes that a large percentage of fertility preservation patients are young women with breast cancer who have time between their surgery and the start of chemotherapy to undergo a cycle to freeze embryos or eggs. It typically requires a two- to three-week time window. Although insurance companies may not always cover this treatment, organizations such as Fertile Hope can greatly subsidize a patient’s expenses. For young girls who are not candidates for oocyte cryopreservation, Johns Hopkins researchers are enrolling patients in a pilot trial of ovarian tissue cryopreservation. In this procedure, clinicians harvest part of the ovarian cortex, where the majority of primordial follicles are found. The tissue is then preserved for future use.
“We are studying the best methods to retrieve and preserve ovarian tissue to use at a future time,” says Christianson. Although this field is still in the early stages, about 30 babies have been born worldwide from cryopreserved tissue.
For more information or to refer a patient, call 443-997-0400