A French infant named Jules is the first in the world to be born using a method called in vitro maturation (IVM) followed by vitrification. His mother is a breast cancer survivor who became infertile after chemotherapy treatment.
In IVM, eggs are matured after they’ve been extracted from the mother, when they’re outside the body. Babies have been born as a result of IVM before, but only in cases where the eggs were immediately fertilized and implanted back into the patient.
In this case, the in vitro maturation was followed by a process called vitrification, which uses liquid nitrogen to freeze the eggs very quickly to lower the chances of ice crystals forming and damaging the cell. It’s the first successful case of IVM followed by vitrification.
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Previous research published in 2018 from the University of Edinburgh found that female cancer survivors were 38% less likely to become pregnant than women who had not faced a cancer diagnosis. Women with breast cancer are some of the worst affected.
IVM could be a game-changer for young breast cancer patients because it doesn’t require them to get hormone injections. IVF, which is a much more widely used option for women struggling with fertility because it has a higher success rate, requires the mother to get hormone injections to pump up ovulation and help the eggs mature while they’re still inside the body.
However, for cancer patients and cancer survivors — as well as women with polycystic ovarian syndrome (PCOS) and women with other reproductive issues — undergoing hormone injections just isn’t a safe or feasible option. Plus, for cancer patients, undergoing weeks of hormone treatments could delay their potentially life-saving cancer treatment.
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The study was published in the journal Annals of Oncology and led by doctors from Antoine Béclère University Hospital near Paris.
The patient, who was not named in the study, was diagnosed with breast cancer at age 29. She was offered two options for saving her fertility: ovarian tissue cryopreservation or IVM.
Ovarian tissue cryopreservation involves removing and freezing a patient’s ovarian tissue and then placing it back into the body once chemotherapy is completed. While this is a successful and effective method that doesn’t require hormone injections, it is an invasive surgery that cancer patients are sometimes hesitant to go through when they have so much other surgery and treatment to face. For some cancer patients, it also presents the possibility of transplanting cancer cells back into the body along with the healthy ovarian tissue.
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The unnamed patient in this study chose IVM, which is a much less invasive procedure and allowed her eggs to be harvested right away. Seven immature eggs were harvested from the patient and matured in a lab, outside of her body. They were then frozen using vitrification.
Years later, after she had beaten cancer and was ready to have a baby, she tried at first to become pregnant on her own but found that she was infertile. So her eggs were thawed and fertilized, and then one embryo was implanted back in her womb.
The pregnancy continued without any complications, and, at the age of 34, the patient gave birth to a healthy baby boy named Jules.
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Professor Michaël Grynberg is head of the Department of Reproductive Medicine and Fertility Preservation at the Antoine Béclère University Hospital. He provided the patient with fertility counseling and performed the patient’s fertility procedures, and he is the first author of the study.
“Fertility preservation should always be considered as part of the treatment for young cancer patients,” Grynberg said. “Egg or embryo vitrification after ovarian stimulation is still the most established and efficient option. However, for some patients, ovarian stimulation isn’t feasible due to the need for urgent cancer treatment or some other contraindication. In these situations, freezing ovarian tissue is an option but requires a laparoscopic procedure and, in addition, in some diseases it runs the risk of re-introducing malignant cells when the tissue is transplanted back into the patient.
“IVM enables us to freeze eggs or embryos in urgent situations or when it would be hazardous for the patient to undergo ovarian stimulation. In addition, using them is not associated with a risk of cancer recurrence.”
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“We are aware that eggs matured in the lab are of lower quality when compared to those obtained after ovarian stimulation,” said Grynberg. “However, our success with Jules shows that this technique should be considered a viable option for female fertility preservation, ideally combined with ovarian tissue cryopreservation as well.”
This case shows a promising new way for cancer patients to preserve their fertility without having to go through hormone injections. We look forward to more success stories.