Aim: To provide equitable access to ovarian and testicular cryopreservation, which requires specialised laboratory techniques, for young patients at risk of infertility because of their cancer diagnosis and treatment, regardless of their geography, gender, and age in Australia.
Method: The National Ovarian and Testicular Tissue Transport and Cryopreservation Service (NOTTCS) was established at RWH in late 2019. This program established a rapid-response process involving liaison with rural and remote centres to provide the opportunity for young cancer patients to have their gonadal tissue retrieved and transported to a centralised fertility preservation centre for processing and storage. The service provides education, consultation, logistic support, and a robust tissue transport protocol to ensure optimal tissue viability prior to cryopreservation. This protocol involves engaging reliable specialist logistics, with transportation in specially conditioned Credo Cubes for optimal quality control. The tissue is transferred in either locally sourced IVF media, or a tissue transport solution. Tissue cryopreservation is performed published international guidelines1. The service operates with a centralised dedicated nurse coordinator and laboratory staff, providing 24 hour support to rural oncology centres. Follow up is provided to the referring centres and the patients.
Results: NOTTCS has successfully provided this service for 56 young patients (50 females, 6 males), of which 15 were younger than 13 years. All tissue samples were received within 24 hours from retrieval sites in all states and territories of Australia. All patients had potentially viable tissue cryopreserved.
Conclusions: NOTTCS has been successfully established, addressing a previously unmet need for access to contemporary fertility preservation for young cancer patients outside tertiary centres. The service provides high level coordination, specialised laboratory conditions for tissue cryopreservation quality control and proven logistical capabilities. We can now provide access to gonadal tissue fertility preservation to all Australians, consistent with current cancer treatment guidelines2.