Many medical conditions, like cancer, require treatment that can impact long term fertility and reproductive health. OTC is a procedure that may allow girls and young women the opportunity to have children later in life by removing and freezing ovarian tissue before these treatments start.
Cryopreserving, or freezing, ovarian tissue requires a surgical procedure, performed at Nationwide Children’s Hospital, in which an ovary or part of an ovary is removed. The tissue containing immature eggs is frozen, and stored at a third party storage facility, for use later in life. This tissue may be re-implanted inside the body, or potentially, the eggs could be matured outside of the body and used later through in vitro fertilization. Although current research is promising, maturing the eggs outside of the body has not yet been done successfully in humans.
Who can benefit from OTC?
Ovarian tissue cryopreservation (OTC) is the only available fertility preservation option for girls who have not yet started their menstrual periods.
OTC may be the only feasible option for young women who have gone through puberty and need to start their treatment urgently.
OTC is only available at a limited number of adult and pediatric institutions in the United States.
Who is involved in the OTC procedure?
A Fertility Preservation Patient Navigator meets with patient, family, and treatment team to determine fertility risk, identify available preservation options, and coordinate team efforts throughout the treatment process. A surgical team meets with the patient & family to discuss OTC, performs the procedure, and provides follow up care after surgery.
How is OTC different from other types of fertility preservation?
Embryo and egg freezing are established forms of fertility preservation available to females who have started menstruating. Freezing eggs requires that young women take a hormonal medication to make many eggs at one time. Embryo preservation requires an available source of sperm.With egg freezing, a male partner can be identified at a later date. These embryos or eggs are retrieved and frozen for future use. This process may require 10 to 14 days to complete.
Ovarian tissue cryopreservation programs are becoming increasingly available, though have only been in existence around the world for approximately 15 years. Because there has been such a short interval of time since OTC has been in use, there is very little information about the use of this tissue in girls that underwent OTC at a young age.However, there have been over 100 pregnancies world-wide to date for women using this tissue in their twenties and thirties.
An OTC procedure takes approximately one hour and may be done as a same day surgery. It also may be combined with other procedures in the operating room to limit the need for additional anesthesia. It is generally performed as a minimally invasive surgery using small incisions in the abdomen.
What happens after the procedure?
After the procedure the ovarian tissue is processed, frozen, and sent to a third party, long term storage facility used by numerous centers across the U.S. It can be stored for many years until the patient is ready to use the tissue.
Stacy Whiteside APRN, MS, CPNP-AC/PC, CPON received both her undergraduate and graduate degrees in nursing from the Ohio State University. As a founding member of the Nationwide Children’s Hospital Fertility and Reproductive Health program, Stacy currently serves as the fertility patient navigator providing counseling and fertility preservation options for all patients with medical conditions or treatments that may impact their future fertility.
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