Of the 1.5 million people in the United States diagnosed with cancer this year, 150,000 of them are under the age of 40. Fortunately for these younger patients, it’s a far less catastrophic diagnosis than it would have been 20 years ago.  This is true in two major dimensions: survivability and fertility.

 

Preserving Fertility after Cancer

As Dr. Teresa Woodruff, winner of The Journal of Women's Health Award for Outstanding Achievement in Women's Health Research, says, “Today most children survive childhood cancer. But there’s something new. The chemotherapy and radiation that enabled their survival no longer has to mean the end of their fertility.”

This statement holds especially true for young girls, thanks to the development of new treatment options that were hardly dreamed of a generation ago.  Benefiting from NIH-funded research, Woodruff and her colleagues pioneered several ways to preserve a young woman’s fertility, including collecting her eggs and cryopreserving them.

But what if the young woman’s need for treatment is so urgent there isn’t time to collect the eggs she’d normally produce?  Or what if she’s too young to have a menstrual cycle and can’t yet produce eggs on her own?

Woodruff and other researchers at the Oncofertility Consortium – a global, interdisciplinary network that she founded –  are studying egg biology at its most basic level. Their investigations have resulted not only in cryopreserving eggs, but also in cryopreservation of the ovarian tissue that contains the eggs.

“At birth a woman has a million follicles in her ovaries and each follicle has an egg,” Woodruff points out. “She has more potential eggs at that time than she will when she’s 30.”

Woodruff and other oncofertility researchers are now able to take small pieces of ovarian tissue and cryopreserve it. While this technique is still experimental, the hope is that by the time the girl becomes an adult, she will be able to her to use her cryopreserved eggs to begin her family.

Fortunately, there is no age limitation to this emerging technique. “It can be done at one month old,” Woodruff’s states.  She hopes no matter the child’s age, parents will discuss the fertility preservation options with their doctors before cancer treatment starts.

EVATAR™, a Body on a Chip

One recent development helping Dr. Woodruff and her colleagues study the basic reproductive science behind these breakthroughs is EVATAR™. This is a 3-D model which Woodruff helped create, and it mimics the female reproductive system. It includes ovaries and can mimic the menstrual cycle and pregnancy hormones.

EVATAR™ uses both human and mouse tissue and can be used to test the efficacy of drugs. It provides a larger picture of events occurring in multiple tissues at once as opposed to the more sharply limited information that comes from growing tissues in a Petri dish.

Woodruff and her colleagues spent five years creating EVATAR™. With EVATAR™ (the name is a cross between “Eve” and “Avatar,”), researchers can test pharmaceuticals and learn their effects without putting individuals at risk, especially a woman who might become pregnant.

Helping people preserve their fertility after a cancer diagnosis is a focus of much of Woodruff’s professional life, but it’s by no means all. For Woodruff, medical research has had a serious blind spot.

Sex Bias in Research: Significant Steps Towards Eliminating It 

Historically, women were frequently excluded from medical research and clinical trials. As a result, therapy guidelines and drug treatments were developed based on the study of one sex and these studies were generalized and applied to both sexes. Too often this resulted in inappropriate diagnosis and treatment for women.

Woodruff has been in the forefront of writing, speaking, and testifying on the need for eliminating sex bias in medical research. Her advocacy efforts did not go unnoticed. In 2016, the National Institutes of Health (NIH) announced a new requirement for NIH funding:  sex as a biological variable must be included in the design of research projects.

NIH officials concluded that considerations of sex were critical to research design in the same way randomization, blinding, and sample-size calculations are essential. The NIH power of the purse means that Woodruff’s long-time dream of eliminating sex bias in research is closer than ever to being fulfilled.

As a Child, Woodruff Never Expected to Be a Scientist

How did Woodruff get to where she is now, a champion of fertility options and a mover in the efforts to have considerations of sex as a biological variable mandated for NIH research funding?

It wasn’t a direct path. “I started out wanting to be a first-grade teacher, like my mom and grandmother,” she reminisces. 

It wasn’t until college when she discovered the allure of research.  “I found my calling,” she remembers, “and everything changed.”

She loves her career in science, finds it fulfilling and recommends it to anyone. “The research we do now benefits not just us, but also the next generation.”

What does it take to be a scientist?  “Be curious, that’s the phenotype of the best scientists.  You need that, but you also need perseverance.” Add in vision, determination, caring, optimism, and willingness to take on the big problems, and you have Teresa Woodruff.