Children and teen cancer patients future-proofing fertility

Cancer patients as young as one are among a growing number of Victorians undergoing fertility treatment to protect their chances of having children.

Cancer patients as young as one are among a growing number undergoing fertility treatment to future-proof their chance of having children.

About 300 Victorian patients — half of these children or teenagers — seek help each year to preserve their fertility after a cancer diagnosis.

Each year in Victoria about 20 to 30 young girls have ovarian tissue removed and frozen before starting cancer treatment.

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Melbourne IVF and Royal Women’s Hospital head of fertility preservation Associate Professor Kate Stern said egg and ovarian tissue freezing were no longer “experimental” treatments.

She said surgery to freeze ovarian tissue had been performed in children as young as 12 months old.

“Of the patients we see, over 80 per cent will chose to do something. The discussion about fertility preservation is now considered a mandatory part of cancer treatment,” Prof Stern said.

Worldwide, only two children have been born using immature eggs frozen before puberty.

“We know that when you graft the tissue from a young girl, the eggs mature normally, but because we’ve only been taking it for a few years we haven’t had cause to put it back yet,” Prof Stern said.

But there is still some way to go before the fertility of boys after cancer can be protected.

An experimental procedure undergone at the Royal Children’s Hospital, the only Australian centre where it is available, treats about 30 boys a year.

It aims to one day grow immature sperm to maturity when they are capable of fertilising an egg; a feat only so far achieved in animals.

Nicole Paterson, Corinne Gebert and Sasha Milinkovic with her children Morris, 3, and Goldie, 6 months. Picture: Jay Town

Ten years ago Nicole Paterson, at age 21, was the youngest Victorian to be diagnosed with cervical cancer.

“I remember when they told me I couldn’t carry my own baby … was the worst day of my life,” Ms Paterson said.

“The cancer didn’t really bother me, because I knew I had a chance to fight it. But with kids, that was taken away from me straight away.”

Ms Paterson froze eggs, embryos and ovarian tissue before starting chemo, radiation and having surgery to remove her cervix and lymph nodes.

Now cancer free, she hopes the new year will bring her and fiance Mark Baumann the opportunity to start their own family through a surrogate.

“We’re feeling positive about it. Most people get to have their own babies, we just want the same chance as everyone else,” she said. “We feel lucky that we’ve got options.”

Corinne Gebert, 35, had a double mastectomy after finding she carried the BRCA mutation, putting her at high risk of ovarian and breast cancer. She is now preparing to freeze her eggs.

“It takes come pressure off me, because I have to start looking at my ovarian cancer risk in five years,” she said. “I wish it could be different and for it to be natural, but you don’t know what’s around the corner. Knowledge is power.”

There are other potential options on the horizon. Prof Stern’s laboratory is working with Danish colleagues to grow an “artificial ovary”.

Sasha Milinkovic with Morris, 3, and Goldie, 6 months. Picture: Jay Town

LIGHT AT THE END OF THE TUNNEL

When Sasha Milinkovic was diagnosed with breast cancer at only 26, having children wasn’t on her radar.

But suddenly, as well as dealing with her cancer, she was asked to consider her plans for a family.

“I knew I wanted children in the future, but it wasn’t on my radar,” Ms Milinkovic said. “The thought of doing IVF, then doing chemo, radiation and surgery — that was just way too much to deal with.”

Instead, she opted for a fertility preservation treatment that temporarily shuts down the reproductive organs during chemo.

Now with partner Dan Finch by her side she is mother to son Morris, born after five cycles of IVF, and six-month-old daughter Goldie, conceived naturally.

“I want people to know there is light at the end of the tunnel,” she said.

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