Only a few years ago, a cancer diagnosis routinely crushed a young woman's dreams for a biological family of her own.
"There were front-page newspaper articles when a woman worked out a way to have a baby after cancer," said Teresa Woodruff, a reproductive endocrinologist. But in 2004, Elias Zerhouni, then director of the National Institutes of Health, launched an ambitious project called "Roadmap for Medical Research."
The "Roadmap" encouraged scientists to "think big and broadly," to put their heads together with all kinds of other professionals, from ethicists to historians —and it "made intractable problems visible," she said. "It was one of those wonderful Brigadoon moments."
As director of the basic-science programs at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University at the time, Woodruff, a biochemistry Ph.D., had been fretting about one of those problems: "You could preserve fertility for boys and men [undergoing cancer treatment], but there was nothing for women," she recalled. She applied for a "Roadmap" grant to address it.
The $21 million NIH grant Woodruff received built the Woodruff lab — all light wood, white walls and stainless steel, in a research building on the NU Feinberg School of Medicine campus. The goal was to preserve the fertility of women whose reproductive organs are disabled by cancer treatment. Woodruff coined a term for the enterprise — "oncofertility."
Woodruff's lab has all the usual research equipment, and something else— four big screens for teleconferencing with people involved in research all over the world, "to share what works and what doesn't work," she says. "We call it telesynergy."
In the past few years, scientists have gained more understanding of how the ovarian follicle works than in the past few decades, Woodruff said.
Using in vitro fertilization to "bank" embryos grown from a woman's egg and her partner's sperm gives the best chance for a baby right now. If a woman is single, though, or the cancer patient is a child, her future fertility may depend on the possibilities inherent in her own tissue.
"That's where our research comes in," she said.
Freezing unfertilized eggs still yields disappointing results, Woodruff said; her lab works with the ovary itself. A woman facing cancer treatment without a partner might have one of her ovaries removed and frozen to invest in the future.
If the ovary turns out to be disease-free, it can be put back in the woman's body after treatment. More than 20 babies have been born from previously frozen ovaries, mostly in Europe, Woodruff said.
The hope is that research will lead soon to techniques for stimulating the ovary's follicles to produce eggs outside the woman's body that can later be fertilized and grown through IVF to produce a healthy baby.
The Woodruff lab has successfully grown eggs from human ovaries, embryos from monkeys' ovaries, and live baby mice. While mice are different in many ways from humans, the lab-grown mice are "proof of the principle" that underlies her lab's work, Woodruff said.
The founder and director of NU's Institute for Women's Health Research, Woodruff is also a strong advocate for mentoring women along the road to working in science, and for including women — and even female mice — as subjects in medical research.
It's all part of her pursuit of more personalized medical solutions that would move away, for example, from the scattershot approach and toxic effects of today's cancer drugs.
"I would like to move from dumb chemicals to smart biologics. Then we could get out of the business of oncofertility," she said.
One solid change Woodruff sees even now is that most cancer patients no longer face treatment "without someone first having the fertility discussion with them. That's the starting point."
Woodruff is not a medical doctor. She did her undergraduate work at Olivet Nazarene University in Bourbonnais, Illinois, her hometown, and her graduate work in biochemistry at NU's Evanston, Illinois, campus. She spent six years at Genentech, a private biotechnology firm in San Francisco, and returned to NU in 1995.
Heading up an organization like the Institute for Women's Health Research is "unusual for a basic scientist," said Neena Schwartz, emerita professor of Biological Sciences in the department of Neurobiology at NU's Evanston campus. Schwartz, who mentored and collaborated with Woodruff when she was in graduate school, called her "a beacon for female students."