Pro & Con: is it reasonable to use ovarian tissue freezing to preserve reproductive potential? (Opinion).

YES

A young woman with cancer who is about to undergo a stem cell or marrow transplant has absolutely nothing to lose in terms of her reproductive future by having one ovary taken out and the ovarian cortex properly frozen.

Cancer patients represent one promising group of candidates for the procedure. The idea is to remove ovarian tissue from an entire ovary and cryopreserve it before cancer treatment, transplanting a small portion of it into nude mice that are immunologically deficient. If there are any cancer cells in that tissue, they should grow in these mice. If there's no tumor growth from this sample, you can feel comfortable transplanting the tissue later when the opportunity presents itself. So far, none of the women who have undergone the procedure have been ready to attempt pregnancy.

The Infertility Center of Saint Louis offers ovarian tissue removal and storage for patients undergoing chemotherapy and other cancer treatments, but we're having a hard time getting insurance to pay for these procedures. The process of freezing isn't too expensive--$500-$800--and then $150 per year for storage. So storing and freezing are not expensive at all, but it costs $5,000 to laparoscopically remove the tissue.

For some benign conditions such as aplastic anemia or lupus in which fertility is affected, there won't be any cancer-related fear of transplanting the tissue. But so far the young women who have undergone the procedure for benign conditions at our center haven't yet requested reimplantation.

What about healthy women who want to preserve fertility? That is a promising application, although I'm not performing it at this time. If it were to become ethically acceptable--and I'm not sure it is yet--then I think this could be a very easy thing to do. It doesn't really await any further research.

The question is whether society is ready for this procedure. We would have to await ethical reviews and a thorough discussion by various ethics committees to make sure that the procedure is well thought-out. It's kind of a bold new concept for society But once, and if, the ethics are found acceptable, it could become very popular.