A programme for freezing ovarian tissue to preserve fertility before cancer treatment in young girls is being launched at the Royal Free London Hospital in Hampstead.
Ovarian tissue freezing is the only fertility preservation option available for pre-pubescent girls who do not yet have mature oocytes to be frozen. The technique is also advantageous in cases of aggressive cancer in women as it doesn't require hormonal treatment, allowing it to be carried out on short notice. Further, unlike oocyte freezing, it allows hundreds of primordial follicles to be stored.
'There is an increasing need for techniques to help women who are diagnosed with cancer at a young age to help preserve their fertility,' said Paul Hardiman, consultant gynaecologist at the Royal Free London Hospital and director of the programme. 'There are a number of ways to achieve that, but for certain groups of women and girls the conventional treatments are not available and ovarian tissue-freezing is the only option.'
Ovarian tissue freezing is carried out by removing an ovary using keyhole surgery. The outer layer of the ovary, known as the cortex, is cut up into tissue strips and stored at -196°C. Once the patient wishes to conceive, after their treatment is complete, these strips can be thawed and implanted back onto the remaining ovary or the pelvic wall.
This procedure was first applied in Denmark 20 years ago, with the first live birth reported in 2004. To date it has led to around 100 births worldwide. This will be the first NHS-funded application of the technique in the UK, but previous procedures have been carried out at hospitals in Oxford and Edinburgh under charitable support. The Royal Free says it has modelled its protocols on those of the largest hospitals in Denmark.
'This is a well-established method in Europe, the US and Japan but the UK has lagged behind and patients often faced having to go abroad and pay to receive this treatment,' said Hardiman. 'At a time when patients need to concentrate on life-saving therapies this intervention needs to take place as quickly as possible.'
The service will be available to patients in the North Central London Clinical Commissioning Group first, but referrals will later be accepted from further afield. The programme could eventually benefit an estimated 1200 patients in the UK.