After chemotherapy left her infertile, a French woman is now a new mother to a healthy baby boy after becoming the first person to successfully undergo an innovative new procedure known as in vitro maturation (IVM).
At 29-years-old, the unnamed woman was diagnosed with grade III invasive ductal carcinoma, breast cancer that tested positive for both estrogen and progesterone. Before undergoing cancer treatment, a woman may be presented with the option to undergo egg retrieval procedures that require hormonal treatment. In her case, this option would have been too risky given the presence of reproductive hormones in her tumor.
Within six days of her diagnosis, doctors performed an emergency procedure to harvest seven immature eggs, foregoing the use of hormones to stimulate and ripen the oocytes – two options that would have taken too long and likely have made her cancer worse. The eggs were then matured in a laboratory using hormonal cultures typical of IVM before being frozen and stored in liquid nitrogen, according to a letter in the journal Annals of Oncology.
Five years later, the woman successfully recovered from breast cancer but found that chemotherapy had left her infertile. Stimulating her ovaries for more eggs would run the risk of causing her cancer to recur, so doctors instead successfully thawed six of her eggs and fertilized five of them using a process called intracytoplasmic sperm injection, which uses a needle to inject the cytoplasm of the egg with a single sperm, notes the American Pregnancy Association. One developed embryo was transferred into the woman’s womb, resulting in a successful pregnancy.
On July 6, 2019, the 34-year-old women gave birth to a healthy baby boy named Jules.
Fertility preservation in young cancer patients has become a prominent area of study, particularly when ovarian stimulation is not feasible. The successful application of IVM in this case offers hope to other women undergoing chemotherapy and hoping to conceive.
"Fertility preservation should always be considered as part of the treatment for young cancer patients. Egg or embryo vitrification after ovarian stimulation is still the most established and efficient option. However, for some patients, ovarian stimulation isn't feasible due to the need for urgent cancer treatment or some other contraindication,” said Professor Michaël Grynberg, head of the Department of Reproductive Medicine and Fertility Preservation at the Antoine Béclère University Hospital, in a statement.
IVM is a viable option for female fertility preservation, ideally when used in combination with tissue cryopreservation, a technique that extracts ovarian tissue for future reimplantation into the female womb.