Conception after transplant

During EBMT 20225, Ms Iebe De Quick, nurse and oncofertility coordinator at Brussels IVF, delivered a presentation on the available options for fertility presentation in oncological patients.

Both for men and women, several fertility preservation options are available. In women, the standard of care consists of oocyte or embryo preservation. However, these techniques require enough time for hormonal stimulation. In case of an aggressive or rapidly progressive disease requiring immediate treatment, oocytes can be collected and matured in the lab through in vitro maturation (IVM). Another option is to preserve ovarian tissue after which ovarian tissue-derived immature oocytes can be successfully matured in vitro (OTO-IVM).

In men, the most frequently used fertility preservation strategy consists of sperm cell or testicular tissue preservation. In prepubescent boys, there is the option for testicular cryopreservation. Interestingly, in 2024, Brussels IVF performed the first testicular tissue transplantation in the world. During that procedure, cryopreserved immature testicular tissue was reintroduced after 16 years in an infertile man who underwent chemotherapy in childhood for the treatment of sickle cell disease.

Several techniques are available to facilitate conception after cancer. In many cases, conception can be facilitated after ovulation induction or cycle tracking. In an oncofertility setting, intracytoplasmic sperm injection (ICSI) is preferred over IVF to maximize the chance for success. In women without a cycle, or ovulation, an ovarian tissue transplantation can be performed. This ovarian tissue can either be placed on the ovary, or in a pouch that is created on the peritoneum.

As such, many different techniques are available to preserve fertility and facilitate conception after cancer. Therefore, oncofertility coaching should nowadays be an integral part of the care pathway for (young) cancer patients.