Division of Fertility Preservation at Northwestern University

Recognizing the unmet fertility management needs of women facing fertility threats, the Department of Obstetrics and Gynecology took an unprecedented step and created a new clinical division, the Division of Fertility Preservation in the fall of 2006.  The mission of the Division is to increase the pace and quality of basic ovarian research and to provide fertility sparing options to young adults with a cancer diagnosis as well as other fertility threatening diseases or disease treatments. Members of the Division explore the molecular mechanisms that underlie normal follicle development, develop methods that support human follicle development and provide information, support and guidance to reproductive-age cancer survivors and other young adults to accelerate research in fertility preservation.  In achieving our mission, the Division of Fertility Preservation is meeting the needs of women within our local community and providing a template for work around the nation.

Dr. Teresa K. Woodruff, a leader in the field of reproductive research, heads the Division.  Dr. Woodruff is a professor of obstetrics and gynecology and of endocrinology at the Feinberg School of Medicine and professor of Molecular Biosciences in the Weinberg College of Arts and Sciences, She was appointed the Thomas J. Watkins Memorial Professor in Obstetrics and Gynecology in 2006 and is the immediate past director for the basic science programs of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.  Woodruff’s career focuses on ovarian biology and interdisciplinary approaches to solving problems in reproductive sciences.  Her team has led the way in the new discipline of oncofertility, encountering patients at the time of a cancer diagnosis, and navigating the patient through the decision making process about fertility and, in some specialized cases, providing the fertility preservation interventions.

The programs within the Division of Fertility Preservation encompass cutting edge research and advanced clinical care.   The Division serves as the coordinating unit between the specialties that comprise the new discipline, created by Dr. Woodruff and coined “oncofertility.”  The participating disciplines include oncology, gynecological oncology, urology, reproductive endocrinology, pathology, biomedical engineering, molecular biology and the behavioral and social sciences including bioethics, health law, policy studies, economics and communication science.   The Division also serves as a centralized resource for information about fertility management for clinicians and cancer survivors while working closely with the Robert H. Lurie Comprehensive Cancer Center (recently designated a Center of Excellence by Fertile Hope, the nation’s leading advocacy organization dedicated to fertility preservation for cancer survivors).

The Division’s goals include:

• Encouraging research that can protect or preserve fertility for reproductive-aged cancer survivors
• Expediting the transition from research findings to clinical practice
• Understanding the decision-making process that cancer patient face when dealing with the potential loss of fertility
• Serving both the professional and general communities as a resource for fertility preservation
• Navigating reproductive age cancer survivors through the clinical options for fertility preservation

Scientific Accomplishments of the Division of Fertility Preservation 

A number of important research objectives have been reached over the past 3 years since joining the Department of Obstetrics and Gynecology.  The results of our work provide new models of human gynecologic disease, support the dogma that the initial follicle pool is necessary and sufficient for lifelong fertility, expand our notions of follicle dynamics prior to puberty, and provide new insights into the structure-function relationships between two reproductive hormones (inhibin and activin) and their cellular targets.  Finally, we have developed an innovative approach to promoting ovarian follicle development in vitro, which provides new methods for fertility management in cancer patients. 

Clinical Services Provided by the Division of Fertility Preservation at Northwestern University.

1. A Nationwide Resource for Fertility Preservation Options. The Division provides patient navigation, provider resources and access to consultations and interventions for fertility preservation options for patients with cancer and other chronic diseases that may impact their fertility. These referrals are provided not only for patients within NMH, NMFF, CMH and RHLCCC but also for patients nationwide through a national referral telephone and web contact resource. Patients and providers nationwide can call 866-708-FERT or contact us via our websites (http://oncofertilty.northwestern.edu or http://myoncofertilty.org) and they receive personalized responses and are triaged as appropriate for consultation and fertility preservation treatments in their own locale.

2. Fertility preservation procedures provided within the Division are part of a comprehensive approach to fertility preservation in men, women and children and include:
• Ovarian Tissue Cryopreservation
• In vitro maturation of oocytes
• Oocyte cryopreservation
• In follicle maturation of oocytes
• Sperm and testicular tissue cryopreservation (as needed)

3. Reference Lab Services for Fertility Preservation provided to other centers within the Chicagoland area. Because of the complexity of some of the laboratory services, equipment and personnel required for fertility preservation procedures, several member centers of the National Physicians Cooperative (NPC) of the Oncofertility Consortium® in our catchment area send tissues to the Division for processing. These centers include:
• Children’s Memorial Hospital
• University of Illinois at Chicago
• Stroger Memorial Hospital

4. Multidisciplinary Education and Training Resources. The Division has initiated a number of educational opportunities for internal and external groups including;
• Monthly multidisciplinary Oncofertility Forum where case presentations, practice guidelines and research projects can be discussed. This Forum includes physicians, nurses and social workers from REI, Urology, Heme/Oncology, Pediatrics, Surgical Oncology; clinical laboratory and research scientists, psychologists, ethicists and all others with interest in patient care in this specialty.
• Educational lectures (with CME credits) for oncology nurses and social workers from throughout Chicago to apprise them of new oncofertility options available to their patients.
• Grand Rounds presentations to specialty groups such as American Society of Rheumatology, American Association of Tissue Banks, Food and Drug Administration, etc.
• Lectures for the Master’s Program in Embryology

5. Regulatory and Management Consulting Services to NMFF Departments and Collaborators. Members of the Division have special expertise in regulatory affairs in clinical laboratories and tissue banks, CPT coding, pricing and billing compliance, program development, tissue bank inventory audit and risk management and IRB submissions in clinical programs. Consulting services have been provided to departments within NMFF (including OB/GYN and Urology) and outside the institution proper (including CMH and NPC member Institutions and Medical Centers). Some of these efforts have resulted in package pricing for fertility preservation that broadens the availability of services to all patients regardless of financial status.

6. Minority Community Outreach.  The Division has forged collaboration with Stroger Memorial Hospital as part of its MBCCOP grant to provide reproductive health and fertility preservation  consultations to its service populations. This resulted in a joint presentation of an interventional  protocol for reproductive health as part of oncology treatment to ECOG. This protocol is under review for national enrollment.  

7. Program Development in collaboration with CMH. A variety of diseases and conditions that develop in childhood can have late effects on organ systems but insights into the impact on the endocrine and reproductive systems have been limited. A collaboration with Hematology at CMH has resulted in inclusion of these studies in the renewal of the “Grant to Support Comprehensive Care for Cooley’s Anemia and Thalassemia.” Patients will be provided with consultations on fertility interventions, will be enrolled in a study to look at endocrine markers of premature ovarian failure and will be offered fertility preservation and consultations on reproductive and sexual health as part of a comprehensive approach to care. New programs that are being developed in conjunction with Medical Genetics at CMH will provide similar services to patients with mosaic Turners Syndrome and other diseases that can impact ovarian reserve.

Community Outreach