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June 20, 2001
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Women Facing Cancer Treatment May Still Have Fertility Options

Young women today are more likely to beat cancer and should be advised about ways to preserve their fertility before undergoing treatment, a Johns Hopkins study suggests.

"Many adolescent and childhood lymphomas and leukemias, as well as solid tumors, can now be cured ... but the long-term consequences of chemotherapy regimens on reproductive potential were not anticipated," says M. Natalia Posada, M.D., a reproductive endocrinology fellow and lead author of the study. "All patients especially women ages 30 or younger undergoing high-dose chemotherapy and bone marrow transplant should be counseled about fertility preservation options."

Posada and colleagues searched through medical literature, looking for studies relating to such options.

The most promising opportunity, they say, is freezing ovarian tissue, banking it and having it re-implanted after cancer treatments are finished. This is possibly the only alternative for child and adolescent patients. Posada cautions that frozen tissue needs to be scrutinized before re-implantation to make sure it harbors no cancer cells.

Another possibility is undergoing in vitro fertilization before chemotherapy to preserve embryos to be used later. This is a good option for women who have a partner and are willing to cryopreserve embryos, Posada says. A future opportunity is drugs called GnRH analogs, which can protect eggs from the effects of chemotherapy. These have done well in tests of animal models; more studies need to be done in humans.

The report was published in a recent issue of the journal Fertility and Sterility.

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