When she was diagnosed with cancer at the age of 26, Rebecca Pryce also learned she would probably be unable to have children. So she took a radical step to try to preserve her fertility: She had her ovaries removed and cryogenically frozen.
Three years ago, Pryce was diagnosed with B-cell lymphoma, a severe form of cancer that affects the immune system. Doctors in Omaha, Neb., told her to begin aggressive treatment as soon as possible. They said she would need months of chemotherapy and radiation followed by a bone-marrow transplant.
But as is the case for many other female cancer patients, there was a double whammy with the diagnosis. In addition to fighting the cancer, Pryce had to cope with the knowledge she would likely have to give up her plans to give birth to a child someday.
"When I got the news I had cancer, I also found out it was worse than anyone thought and the treatment more severe than I had imagined," Pryce, now 29, told ABCNEWS Good Morning America. "I initially thought, 'After I get through it all, I can get my life back to normal.' But then when I was told I probably would not be able to have children, that hope disappeared."
The drugs that kill cancer cells can also destroy a woman's eggs. Up to 80 percent of women and 90 percent of men who are in their reproductive years become sterile after going through chemotherapy, radiation or surgery on reproductive parts of the body.
To the Freezer
Pryce's siblings, who are both doctors, told her about Dr. Kutluk Oktay, a reproductive medicine specialist at New York Presbyterian Hospital who had pioneered an experimental ovary-freezing procedure.
The idea is to remove their ovaries and cryogenically freeze them until a woman is ready to become pregnant. If the uterus is healthy, the fertilized embryos may be implanted in the patient's womb so she may carry the fetus. If the uterus is not sound, a woman could choose to have a surrogate carry the fetus.
Oktay has removed and frozen the ovaries of about 100 women. So far, two women have had their once-frozen ovarian tissue implanted, but neither has become pregnant thus far. Only one of the two resumed menstruation, and though doctors were able to retrieve a viable egg, the fertilization was not successful, Oktay said.
He hopes to have a viable pregnancy by the end of the year.
For Pryce, whose cancer has been in remission for two years, the procedure creates hope where none existed. A test showed that her uterus has enough lining and wasn't damaged by the chemotherapy, so she should be able to carry a child. She has not yet had her ovaries reimplanted.
Facing Limited Options
When Pryce first learned about the cancer and her fertility issue, she thought the most obvious solution would be in vitro fertilization, which would involve fertilizing her eggs in a lab and then cryogenically freezing them until she was ready to become pregnant.
But that wouln't work for Pryce. Because of the severity of the cancer, she needed to begin chemotherapy right away, and she didn't have time to take the hormone therapy to produce the eggs or to find a sperm donor.
Freezing unfertilized eggs wasn't an option because, again, she didn't have the time for the hormone therapy required. So, she turned to Oktay.
Oktay said that having ovaries removed is a simple outpatient procedure that takes less than an hour and is done under general anesthesia.
"We usually remove one ovary and leave the other in the hope the patient will not become menopausal after chemo," Oktay said. "But in cases where that is certain, we remove both ovaries."
The ovary is then sliced into smaller pieces, which are frozen and put into storage, where they can be left permanently and remain viable, Oktay said.
Ovaries Transplanted in Forearm
When the ovary is transplanted back into the woman's body, instead of going back in the abdominal area, the ovary tissue is implanted under the skin of the patient's forearm. The rationale is that the location makes it easier to monitor for cancer and simpler to remove eggs.
Once back in the body, the tissue would function in the same way it did in its original position, secreting reproductive hormones that would restore regular menstruation and, if all goes well, produce mature eggs that could be harvested for in-vitro fertilization.
That was the case with the one patient who had an ovary reimplanted.
"In the middle of her cycle, she can see a small lump on her forearm which is the egg," Oktay said. "We simply use a needle to extract it, almost like drawing blood."
Because this treatment is experimental, insurance does not cover the procedure. Ovary removal costs anywhere from $6,000 to $8,000. So far, doctors have not charged for the storage or the transplants, since the women involved are part of their research. Sperm banking costs about $1,500.