24 Jan 2023 Cryopreservation-a Message of Hope

As 2023 begins to take shape, hope for intended parents struggling to find their path in the infertility world continues to grow, and it is partly owed to an old friend, cryopreservation. Since its inception over 50 years ago, cryopreservation continues to be a part of new innovations bringing new possibilities as technology branches off into other avenues. As researchers, doctors, and scientists broaden the landscape in the fertility world, cancer patients, embryo donation recipients, and war veterans now have new possibilities when it comes to fulfilling their dreams of parenthood.

Cancer Patients Give Birth after Freezing Their Ovaries During Treatment

Developed during a clinical trial study at the St. Marianna University School of Medicine in Japan, a new fertility treatment technique may have the ability to help women who undergo certain cancer therapies. The procedure involves minimally invasive surgery to remove the ovaries, quickly freezing them after removal and then storing them in a cryobank while the patients go through cancer therapies. Once the patients have completed their therapies, the ovaries are then thawed out and surgically reimplanted in the lower abdomen.

According to Health Trends,  three cancer patients in the study, who froze their ovaries while going through cancer therapies for breast cancer and malignant lymphoma, have successfully given birth in Japan. The women in their 30s and 40s were able to become pregnant naturally or via in vitro fertilization.

Shizuka, a 42-year-old nurse, had one of her ovaries removed after her breast cancer diagnosis and then replaced after her treatment was completed. She was able to become pregnant via in vitro fertilization, telling Health Trends, “I wanted to have a chance to get pregnant and give birth after my therapy, in order to work on my cancer treatment positively.”

Some radiation and chemo treatments can affect a female’s fertility. For example, chemotherapy kills fast-growing cancer cells but kills other fast-growing cells in the body as well. According to the American Cancer Society, estrogen which is needed to release eggs each month is made in oocytes, cells in the ovaries. Oocytes divide quickly and thus are affected by chemo. This loss of hormones can lead to fertility issues as well as sometimes putting women into early menopause. Likewise, radiation near the abdomen or pelvis can damage some or all of a female’s eggs causing fertility issues.

Not only does this new fertility preservation technique help women of childbearing-age, but it also gives hope to young female pediatric cancer patients, who haven’t yet had a period and whose eggs cannot yet be harvested, that they may still be able to have children in adulthood. A female human is born with all the eggs she will ever have, and so to be able to freeze a pediatric patient’s ovaries and store them while she goes through treatment means her eggs will still be viable and healthy when she becomes of childbearing age. Health Trends goes on to say that as technology advances, and doctors can now harvest adult patient eggs at any time, St. Marianna’s clinical study will be shifting its focus to help pediatric cancer patients to increase their chances of fertility in the future.

Twins Born from 30-Year-Old Frozen Embryos

Cryopreservation also continues to provide hope to intended parents seeking embryo donation. This past fall, Rachel Ridgeway and her husband Phillip gave birth to twins using 30-year-old donated embryos, a new record for the longest frozen embryo resulting in a live birth. Previously, as we wrote in an article in 2020, the record had belonged to a Tennessee couple who used a 27-year-old frozen embryo which resulted in a live birth, ousting her big sister Emma, born from a 24-year-old embryo, from the title.

The 30-year-old embryos, frozen in 1992, were kept in a cryobank on the West Coast until 2007, when an anonymous couple donated them to the National Embryo Donation Center in Knoxville, Tennessee. Upon choosing these embryos, Phillip states in CNN, “We weren’t looking to get the embryos that have been frozen the longest in the world. We just wanted the ones that had been waiting the longest.” The embryos had been placed in a special category called “special consideration,” which meant it had been hard to find recipients for them. The Ridgeways, who already had four children, specifically asked for embryos in this category.

Of the five embryos donated and thawed, three were viable and transferred, and two were successful. Timothy was born at 6 pounds 7 ounces, and Lydia was 5 pounds 11 ounces.

The Ridgeways’ doctor, John Gordon, says for CNN, “If you’re frozen at nearly 200 degrees below zero, I mean, the biological processes essentially slow down to almost nothing. And so perhaps the difference between being frozen for a week, a month, a year, a decade, two decades, it doesn’t really matter.”

Study to Help War Veterans with Infertility

Hope may also be on its way to war veterans, thanks to the miracle of cryopreservation.  According to Yahoo News, in a new study, the Department of Veterans Affairs will partner with the fertility clinic Legacy in order to analyze why infertility rates for veterans who served in Iraq and Afghanistan are twice as high as civilian males. Researchers plan to collect the sperm of 1,000 war veterans in order to study this anomaly more closely. They will be looking at a multitude of variables including burn pit exposure, post-traumatic stress disorder, and combat-related injuries, including metals from bullets. The sperm will be tested, then frozen, and then thawed six months later for more testing to account for any variables.

John Crowley, head of military affairs at Legacy, says in Yahoo News, “There are a lot of parameters we can look at from a single sample. For the Defense Department and VA, this will help them see where the sperm are underperforming and why, with respect to deployments and associated injuries.”

This study comes as many veterans complain of lack of help or guidance when it comes to fertility issues and say their complaints have largely been ignored. Senior VHA official Dr. Ryan Vega says in the Daily Mail that as a physician he has “witnessed firsthand veterans struggling with family building”, and he believes the study would help shed light on the challenges faced by many ex-service members.

As new assisted reproductive technologies evolve, cryopreservation continues to play a steady supporting role in the fertility world. For over 50 years, we have relied on it as new innovations make the once impossible possible. Even as political polarization and a right-leaning U.S. Supreme Court pose the greatest threat to reproductive rights since the advent of IVF in the 1970s, reading these stories over the last few months leaves us optimistic that a path to parenthood will one day be available to everyone who desires it, regardless of circumstances.