Welcome

Site:  Northwestern University
Principal Investigator:  Teresa Woodruff, PhD

Rationale

While advances in radiation and chemotherapy have improved survival rates, these treatments may also permanently impact the reproductive capacity of cancer survivors.  Nevertheless, fertility preservation technologies have made the phrase “families after cancer” a reality for many young women. 

The role of the new oncofertility specialist is to bridge the gap between oncology and reproductive medicine and help patients navigate the available fertility preservation options and provide individual solutions based on factors such as age, partnership status, time constraints prior to cancer treatment, planned treatment regimen and overall medical condition. To provide this information to patients effectively, it is necessary to first evaluate the reproductive axis and its response to cancer treatment in a rigorous manner. 

Unfortunately, there are few options for fertility preservation that can be offered to children and young girls diagnosed with cancer and other serious diseases. Development and application of new technologies that can be offered regardless of age is necessary to expand the possibility of having a family after cancer to to all female patients diagnosed with cancer.   

The objectives of this project are to:

• Assess ovarian function and develop methodology for predicting the risk of impending premature ovarian insufficiency based on a young woman’s cancer treatment plan

• Evaluate the toxicity of existing and new chemotherapeutic agents on in vitro follicle culture survival and maturation in order to determine a relative fertility risk

• Optimize current in vitro follicle culture methods in established murine and non-human primate models and translate the successful system into methods that support human follicle growth, steroid production and oocyte maturation in vitro

 

Key Experiments

• Perform a longitudinal study of women with a new cancer diagnosis to measure their ovarian reserve before, during and after cancer treatment using ultrasound imaging of the ovaries, serum hormone levels, ovarian blood flow and follicle attrition

• Add varying doses of the main types of cancer therapeutic agents, and any newly developed drug therapies, to the established murine follicle culture model for the identification of trends in the type of in vitro damage caused to the follicle

• Create the optimal in vitro environment for growth of human follicles by collectively providing the proper mechanical support, growth factor and hormone contribution exposure in a time and stage dependent manner

   

Consortium Support and Impact

The successful execution of this project and eventual translation of results to the clinic require close collaboration with other members of the Oncofertility Consortium. Specifically, cooperation with the Biomaterials Core  and two other Consortium projects that are focused on new methods for follicle cryopreservation and maturation of ovarian follicles in nonhuman primates will be paramount to achieving project goals. In addition, the ability to recruit patients through the National Physicians Cooperative will provide sufficient materials and statistical power to correlate treatment and outcomes data in a comprehensive and thorough manner and to rapidly disseminate new developments for clinical application.  Other Consortium projects will be impacted by the human application of in vitro follicle maturation. This work is expected to open up new avenues of social and ethical inquiry in oncofertility, particularly with regard to its application in pediatric cancer patients. Education of patients and physicians and training of oncofertility specialists will also be necessary to ensure that new fertility-conserving techniques become part of routine cancer care worldwide.

*This research is funded by an R01 grant mechanism within the NIH Interdisciplinary Research Consortium Grant (NIH Grant: U54RR024347)