Ovarian Reimplant Developed Controversial Procedure Could Help Avoid Infertility

Doctors are offering what they say is a new means of helping women with cancer avoid infertility from chemotherapy and radiation: They remove an ovary before the treatment begins, freeze it and then reimplant part of it later.

“There are going to be some patients who are going to want to at least have the option of this,” Dr. Edward Fugger, a biologist who will oversee the freezing and storage at the Genetics and IVF Institute in Fairfax, said Tuesday.

No woman has yet undergone the entire procedure, however, and some cancer specialists are skeptical about whether it would have the desired results or is even necessary.

In Britain, the doctor who developed the technique recently removed ovaries from four cancer patients. None has yet had the organ reimplanted because it can be years before a cancer patient is certified as healthy, Fugger said.

Treatment for cancer often destroys the ovaries. Tens of thousands of women of childbearing age undergo chemotherapy or radiation annually.

Some doctors warned that reimplanting the ovary could jumpstart cancer in remission or cause ethical problems if a woman became pregnant and then suffered a relapse of cancer.

Dr. J. Taylor Wharton, chairman of gynecological oncology at M.D. Anderson Cancer Center in Houston, said the new procedure should be more rigorously tested.

The British researcher who developed the technique, Roger Gosden of the University of Leeds, published a study in April 1994 that showed that the technique works in sheep.

“I’m not condemning it, but I’d have to be convinced it was in a patient’s best interest,” Wharton said.

And he said women may have other options. Among his patients, about 40 young women with ovarian cancer have later gotten pregnant, he said. In most cases, those women had one ovary removed and then received radiation that did not affect the surviving ovary, he said.

But Dr. Beth Karlin, who holds the same title at Cedars-Sinai Medical Center in Los Angeles, said the procedure offers great promise, especially for breast cancer patients.