Oncofertility Consortium

FAMILY TRAVELS TO RHODE ISLAND FROM OHIO FOR FERTILITY PRESERVATION FOR TWO-YEAR-OLD GIRL

Having a child diagnosed with cancer is a parent’s worst nightmare.  But juxtaposing the knowledge that your child may survive, and then may never be able to naturally have children of her own, can be heart-wrenching.  On Tuesday, March 1, 2011, Jared Robins, MD, a reproductive endocrinologist and leader of the Program for Fertility Preservation at Women & Infants Hospital, cryopreserved an ovary of a two-year-old girl from Ohio who is battling a stage four neuroblastoma.  This surgical procedure, which was performed at Hasbro Children’s Hospital, offers the hope of fertility when this patient survives her treatment.

Once their daughter was diagnosed, the Ohio family met with oncologists from the Cleveland area and were told there was nothing that could be done to preserve their daughter’s fertility throughout her cancer treatment.  Their own research led them to Dr. Robins.

While the family is choosing to remain anonymous, the father said, “Time was of the essence, as we only have a three- to four-week window before our daughter will have her stem cell transplant, destroying her fertility.  Dr. Robins called us back within 45 minutes of our initial call.”

Dr. Robins then contacted Jennifer Welch, MD, pediatric oncologist at Hasbro Children’s Hospital and co-principal investigator with Dr. Robins of a unique program that offers ovarian preservation to children who undergo cancer treatment.  From there, a multidisciplinary team that also includes the Division of Pediatric Surgery at Hasbro Children’s Hospital set out to organize the family’s travel to Rhode Island and to coordinate a laparoscopic procedure to harvest the girl’s ovarian tissue.  With the help of the Hasbro operating room staff and in close collaboration with the Providence Ronald McDonald House, the child underwent the surgical procedure the morning after her arrival, and the family could travel back to Cleveland the next morning.

The father commented, “We have been so impressed by the entire team.  We wanted the experts, but we also wanted someone who would make us feel comfortable.  We have felt that here.”

It is estimated that 1 in 500 children will be diagnosed with a form of childhood cancer.  With the use of aggressive treatment modalities, more than 80 percent of these children will be cured. Therefore, many of these children and their parents are looking beyond the cancer at important quality of life issues including future children.

Unfortunately, some aggressive treatments for cancer can render a child infertile.  The likelihood that this will occur depends on the child’s age, type of cancer and treatment plan.  The Program for Fertility Preservation at Women & Infants offers options for fertility preservation in children, in coordination with the Division of Pediatric Hematology/Oncology at Hasbro Children’s Hospital.

This program offers an experimental procedure that enables physicians to freeze tissue from the ovaries before they are damaged.  Once the child is cured of her cancer and ready to have children this tissue may be transplanted back into her body or eggs may be extracted from the tissue for in vitro fertilization.

These experimental studies are being conducted with the support of the National Institute of Health’s Oncofertility Consortium, with the hope of determining how best to freeze the ovarian tissue of young girls.  The Women & Infants /Hasbro site is one of only a few in the country and the only one in New England to be enrolling children.

Last year, the pediatric oncofertility team at Women & Infants and Hasbro Children’s hospitals completed a surgical procedure on a 17-month-old Rhode Island girl who is battling cancer.  This is the youngest known patient to undergo pediatric fertility preservation under the Oncofertility Consortium.

Dr. Robins said, “Freezing part of a child’s ovary to preserve her fertility 20 or 30 years down the line is a research procedure.  Although we are far from knowing all of the facts about its efficacy, we do believe that we can give a hope of fertility to these young cancer survivors.”

Each year, the pediatric oncology program at Hasbro Children’s Hospital sees approximately 60 new patients diagnosed with cancer. As a treatment plan is developed, sometimes it may likely lead to loss of ovarian function in young female patients. Dr. Welch discusses the possibility of harvesting ovarian tissue with patients and coordinates with the pediatric surgeon and Dr. Robins’ team. Ideally, harvesting can be done at the same time as another oncology-related operation on the child at Hasbro Children’s Hospital. Both teams are present in the operating room, and Dr. Robins continues fertility preservation procedures from there on.

For information about fertility preservation services for adults or children, call the National Fertility Preservation FERTLINE at (866) 708-3378 or Women & Infants Program for Fertility Preservation at (401) 453-7500 in Rhode Island.

About Women & Infants Hospital

Women & Infants Hospital of Rhode Island (womenandinfants.org), a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns and a U.S.News Best Hospital in Gynecology.  The primary teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women’s medicine, Women & Infants is the seventh largest obstetrical service in the country with more than 8,500 deliveries per year. In 2009, Women & Infants opened the country’s largest, single-family room neonatal intensive care unit. The hospital is also a member of the Oncofertility Consortium's National Physician's Cooperative, a network of clinical sites dedicated to preserving the fertility of young cancer patients.

New England’s premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility, as well as the nation’s only fellowship program in obstetric medicine.

Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence.  It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute’s Gynecologic Oncology Group.

About Hasbro Children’s Hospital

Hasbro Children’s Hospital (www.hasbrochildrenshospital.org) in Providence, RI, is the premier pediatric facility for clinical care, research and education for Rhode Island and surrounding southeastern New England.  A private, not-for-profit institution, it is the pediatric division of Rhode Island Hospital.  Rhode Island Hospital is the principal teaching hospital of The Warren Alpert Medical School of Brown University.  It was ranked among the top 30 children’s hospitals in the country by Parents magazine in 2009.

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