05 August 2019
New Delhi: A 40-year-old woman suffering from breast cancer for over five years has delivered a boy through in vitro fertilization (IVF) method.
The patient Radhika (name changed) was diagnosed with breast cancer with cancerous changes without any metastasis, seven years ago and was undergoing treatment. She had been married for 17 years and decided to go for artificial reproductive techniques to enjoy motherhood.
The couple underwent a series of tests. The reports revealed normal semen analysis, but she had a poor ovarian reserve due to repeated chemotherapy cycles and cancer medications.
However, before starting the treatment for cancer Radhika had her ovaries frozen, said Dr Mandavi Rai, IVF expert at Indira IVF Hospital, here, who treated her.
"Moreover with a endometrium (the mucous membrane lining the uterus) of 5.2 mm thickness against the normal 7-12 mm thickness it was impossible for Radhika to conceive. Such complications are crucial for patients and it's the most difficult aspects of IVF procedure. Multiple procedures, including platelet-rich plasma therapy (PRP) to thicken her endometrium before the actual IVF procedure were performed. Her decision to get her eggs frozen before starting the cancer treatment helped," said Dr Rai.
According to doctors, PRP therapy is proving to be a boon for such patients. The therapy involves extracting platelets through the centrifugation process from the patient's blood. The therapy also improves the body's resistance. The patient underwent three PRP therapy sessions with 3-5 ml of platelet-rich plasma injected at regular intervals. Significant growth was observed after each session. The thickness of endometrium at the end of 14-day therapy was found to be 8.2 mm, which is enough to conceive and healthy implantation of the embryo through IVF technique.
For Radhika, once the once the endometrium lining reached 8.2 mm progesterone was started with the help of her frozen eggs and her husband's sperms leading to formation of embryos, which were cultured until two blastocysts were transferred. After four weeks, an ultrasound confirmed intrauterine gestational sac with cardiac activity.
"High-risk obstetric care was provided throughout the treatment. The patient underwent elective caesarean and delivered a boy, weighing 3 kg with no abnormalities," said Dr Mandavi.
Terming it a unique case, doctors said delivering a baby by cancer patients post chemotherapy gets tougher with the age.
"Cryo-preservation and PRP techniques are gaining popularity among Indians. Several working women, especially in their early 30's, have started opting for egg freezing," said Dr Sagarika Aggarwal, a Delhi-based gynaecologist.
"Hemotherapy, which is treatment involving the administration of fresh blood, a blood fraction, or a blood preparation, in most cases acts as a big challenge for IVF treatment as chemotherapeutic drugs deplete the quantity as well as quality of eggs. Conceiving after cancer treatment through IVF is rare and the success rate is very low," said Dr Nupur Gupta, gynaecologist, Fortis Memorial Research Institute, Gurgaon.