Innsbruck Clinic Removes Ovarian Tissue from Young Girls – Fertility Preservation Rarely Implemented

As a report indicates, over a period of 18 years, such fertility preservation was actually carried out for only a very small proportion of the children affected. The data suggest that the possibilities for fertility preservation are frequently not fully exploited in clinical practice.

Fertility Preservation: Rarely Implemented

Bettina Böttcher, board member of the FertiPROTEKT network and senior physician at the Department of Gynecological Endocrinology and Reproductive Medicine, explained that in the past, care had been strongly focused on the survival of the young patients. "Die Fertilität und damit verbundene Beratungen spielten so gut wie keine Rolle, sondern es ging primär ums Überleben der jungen Patientinnen," Böttcher said verbatim.

The report also points to possible long-term consequences of treatment that, without prior fertility preservation, can affect the later lives of those affected. According to specialist societies, these include premature ovarian failure, infertility, and the associated psychological burden.

Böttcher emphasized that the procedures at the Innsbruck Clinic are carried out only within a narrowly defined medical framework. The prerequisites are a well-founded oncological or other medical indication, as well as the consent of the legal guardians. The removed tissue samples are cryopreserved and can be reimplanted in the patients at a later date.

Medical Framework and Consent

International guidelines recommend that families with children who have cancer be informed about fertility preservation at an early stage. Studies from Europe show, however, that implementation in many clinics lags behind the recommendations because emergency treatments take priority and specialized counseling structures are lacking.

The Innsbruck Clinic is considered one of the few centers in Austria to offer the full spectrum of fertility-protective measures for minors. In addition to the removal and freezing of ovarian tissue, this also includes medical procedures to protect the ovaries during chemotherapy. Which method is used depends on the age of the patient and on the planned treatment regimen.

Expert Calls for Better Structures

Specialists see the report now presented as a signal to strengthen the structures for fertility counseling in pediatric oncology. These include trained contact persons, clear treatment pathways, and closer cooperation between pediatric oncology and reproductive medicine centers. The topic should also be more firmly anchored in the education and training of physicians.

The Medical University of Innsbruck points in this context to ongoing research projects that examine how fertility preservation for children and adolescents can be better integrated into everyday clinical practice. The findings are to feed into future treatment guidelines, among other things.

Patient organizations are demanding that affected families in future be informed mandatorily and at an early stage about all options for fertility preservation. Only in this way can those affected later make an informed decision about a possible reimplantation of the frozen tissue.

The discussion around fertility preservation in minors is also being followed with attention in Germany and Switzerland. Comparable case numbers exist at several European university hospitals, although the exact figures vary depending on the registry and method of recording.

Overall, the report shows that awareness of the long-term consequences of oncological treatments has grown in recent years, but that the practical implementation of fertility preservation in young patients remains a challenge. The Innsbruck experience could serve as a model for other clinics in order to improve care in this area.