OU Health First in State to Offer Ovary Tissue Freezing Procedure: Offers Future Fertility Hope for Segment of Patients

An innovative new fertility preservation option offered at OU Health is giving new hope to patients who face medical treatments that are likely to impair their ability to conceive a child.

The procedure, called ovarian tissue cryopreservation, or ovary tissue freezing, benefits a segment of patients who previously had limited choices: Those who may want to start a family in the future but must quickly begin a lifesaving treatment like chemotherapy or radiation. OU Health is the only health system in Oklahoma offering the procedure and performed the first one in 2023.

Fertility treatments have existed for years, including in vitro fertilization and embryo freezing. However, IVF typically takes two to three weeks, during which a woman receives medications to stimulate her body to produce follicles (where eggs grow), followed by a procedure to remove the eggs. But if a woman has been diagnosed with an aggressive cancer or other disease, she often must begin treatment right away, leaving no time for traditional fertility preservation.

That’s when ovary tissue freezing may be the ideal choice. At OU Health, reproductive medicine physicians like Heather Burks, M.D., are available to consult with patients who soon will undergo surgery or start treatment, often for cancer. She explains how their fertility will likely be impaired and presents options for trying to have a child in the future, including ovary tissue freezing.

“This is often an anxious time for patients and families. But the conversations we have can go a long way toward their healing process because we’re not just talking about what is happening now, but what can happen in the future,” said Burks, who also serves as an associate professor of obstetrics and gynecology at The University of Oklahoma College of Medicine at OU Health Sciences.

The process of ovary tissue freezing takes place quickly and must be accomplished before a treatment like chemotherapy begins. Through a minimally invasive procedure called a laparoscopy, the physician makes small incisions in the abdomen, then uses a camera and small instruments to remove one whole ovary. The second ovary is left in place in case the patient ends up having some ovarian function after medical treatment.

The next stage is highly coordinated. A courier travels by plane with the ovary to Pennsylvania, where a specialized laboratory at the University of Pittsburgh begins the next stage of the process. The ovary is cut into strips for safer freezing, protected in a special solution, then frozen in liquid nitrogen until a woman is ready to have it reimplanted.

“This expertise is not yet widely available, and the University of Pittsburgh is a foremost expert in ovary tissue freezing,” Burks said. “We have an agreement with them to process and store the tissue. It’s nice to have this option for patients who aren’t candidates for egg or embryo freezing.”

Ovary tissue freezing is also an option for girls who have not yet gone through puberty and need to start medical treatment for a disease like cancer that likely will send them into menopause. In that case, parents make the decision to freeze their child’s ovarian tissue so she has the potential for pregnancy one day. Medication to induce puberty and long-term hormone replacement therapy will be necessary, but in the future, the ovarian tissue can be reimplanted when the patient is ready to try for a pregnancy.

For girls, the procedure to remove and process the ovary is the same as for adults. Lisa Moon, M.D., a pediatric and adolescent gynecologist at OU Health, consults with families who are considering this step. Families’ lives have been upended by their child’s diagnosis with a serious disease like cancer, she said, but they often find hope in conversations about their child’s future.

“It can be overwhelming for families, but it can also become a hopeful situation because we’re talking about their child’s future fertility after they’ve survived their cancer. We’re thinking long-term, which is important for them,” said Moon, who is also an assistant professor of obstetrics and gynecology in the OU College of Medicine. “It can also be comforting for families to know that their child’s whole body is being taken care of, not just the cancer. It’s about everything that comes along with it — they’re a person, not a disease.”

In 2023, Moon performed OU Health’s first ovary removal for cryopreservation. The patient was a 6-year-old girl from Tulsa who was born with sickle cell disease and would soon undergo a bone marrow transplant, which would make fertility unlikely in the future. The family learned that OU Health was offering ovary tissue freezing and decided to preserve their daughter’s ovary so that she would have the option of trying to have children in the future.

Anna (we have decided to not use the patient’s real name due to her age and sensitivity around the topic) underwent the ovary removal procedure several days before beginning the radiation and chemotherapy that was necessary before her bone marrow transplant. Anna has endured a significant amount of pain and health complications because of her disease, her mother said, and the option of preserving her ovary felt like creating hope for her child’s future. Anna’s parents plan to tell her about the procedure when she gets older.

“One day, she will have the option of having children of her own if she wishes,” her mother said. “It is a priceless gift. We are truly thankful.”

The ovary tissue freezing program will also have a research component so that physicians can gather data that could be used to improve the procedure. Studies will focus on use of the ovary tissue; pregnancy and delivery rates; and whether menstrual cycles return after treatment for patients who have not yet gone through puberty.

The downside of ovary tissue freezing is that most insurances do not cover it. OU Health physicians are transparent about the costs, but they are also taking steps to grow the OU Foundation’s Michelle Hastings Fertility Fund, offered through OU Health Stephenson Cancer Center at the University of Oklahoma Health Sciences.

“We have enough funds to make ovary tissue freezing more attainable for patients and families, and ultimately, we would love for all patients who need fertility preservation to have their procedures covered,” said OU Health reproductive medicine physician and OU College of Medicine professor LaTasha Craig, M.D., who created the fund. “Ovary tissue freezing is an exciting advancement, and we want all those who need fertility services to have the opportunity to undergo the procedure that is best for them.”