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UAE: New treatment allows women to conceive after cancer treatments, genetic disorders

OTC is an advanced technique that preserves ovarian tissue in women who are undergoing treatments that could affect ovarian function

Twenty years ago, when an Emirati girl needed a bone marrow transplant, she faced the risk of permanent infertility. The 9-year-old's parents chose to take her abroad for a pioneering procedure known as ovarian tissue cryopreservation (OTC), which offered the hope of enabling her to conceive children

Now, the innovative technique has been performed in the UAE for the first time at HealthPlus Fertility, in collaboration with Cleveland Clinic Abu Dhabi. "This is a groundbreaking procedure and will change the lives of many patients,” said Dr Monika Chawla, medical director at HealthPlus Fertility.

The doctor explained that OTC is an advanced technique that preserves ovarian tissue, especially in women who are undergoing treatments that could affect ovarian function, such as cancer treatments like chemotherapy or radiotherapy. In this procedure, doctors take the whole or part of the ovary, slice it into small slivers, and then preserve it in the lab, keeping it frozen.

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“This can be later brought out and placed back into a woman's body,” she said. “It will then bring back her fertility functions as well as the hormonal functions which the ovary provides to a woman.”

The first live birth using this technique was reported in 2004. Although research is still underway on the technique, the American Society of Reproductive Medicine has accepted it as a viable fertility technique.

Who benefits from this

Egg and embryo freezing have long been the preferred methods to maintain fertility among women who undergo invasive radiation and chemotherapy for diseases. However, according to Dr Monica, this cannot be applied to certain sections of women.

“Very young girls who've been diagnosed with cancer cannot go through egg freezing,” she said. “They have immature eggs at that time. Also, some patients with very aggressive forms of cancer, once they are diagnosed, don't have enough time to even wait for two to four weeks of hormonal stimulation. This is because chemotherapy and radiotherapy need to be started very, very soon after the diagnosis is made.”

She said some hormone-sensitive malignancies also make it impossible for patients to take the hormone injections needed for egg freezing. The technique involves the patient undergoing laparoscopic surgery to obtain tissues that can be frozen for a lengthy period, and Dr Monica said it had some advantages. “It can restore both the fertility function and the endocrine or hormonal function,” she said.

Women who have genetic mutations like Turner Syndrome and severe endometriosis are also candidates for whom OTC will be beneficial. “Right now, we are concentrating on genetic cases, oncology cases and patients with diseases like sickle cell anaemia and thalassemia, which are the hematopoietic disorders which need a bone marrow transplant.”

In the UAE

The technique has now been performed on a 32-year-old Emirati patient with Hodgkin lymphoma, a type of cancer that affects the lymphatic system.

“She was diagnosed at the Cleveland oncology centre and then she was referred to us to the fertility preservation unit,” said Dr Monica. “The laparoscopy was then carried out, and one of the ovaries was removed. This lady is currently undergoing her chemotherapy. It will take a couple of years for her to go through the entire treatment, and then hopefully we will be able to re-implant the tissue in her so she can have babies.”

The first Emirati girl who underwent the procedure in 2004 later got her ovarian tissue re-implanted and gave birth to a healthy baby boy. “This technique will be a great blessing to people like her with genetic diseases and who have cancer,” she said.

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