Fertility Preservation
may be used by women who elect to delay child bearing for medical,
professional or personal reasons. The primary indications for Fertility
Preservation include:
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For women diagnosed with cancer who wish to freeze
eggs before starting chemo or radiation therapy which damages the eggs and
may cause later infertility or sterility. Over 50,000 reproductive-aged
women are
diagnosed with cancer
annually in the United States. Some chemotherapeutic and radiation regimens
are toxic to the ovaries and destroy eggs. Combination chemotherapy regimens
and radiotherapy commonly produce menstrual irregularities as well as
infertility. Total-body irradiation used in the preparative regimens for
bone marrow transplantation is damaging to endocrine and ovarian function.
Ovarian damage is drug- and dose-dependent and is related to age at the time
of treatment, with progressively smaller doses producing ovarian failure as
the patient’s age increases. Total body, abdominal, or pelvic
irradiation may cause ovarian damage, depending on the dose, fractionation
schedule, and age at time of treatment. Women should consult their
reproductive endocrinologist and oncologist to evaluate their individual
medical and personal needs in selecting the most appropriate Fertility
Preservation technology. In the setting of a newly-diagnosed cancer,
embryos, eggs, or ovarian tissue may be frozen as a medical emergency to
minimize any delay of cancer treatments.
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Before treatment for autoimmune or benign systemic disease
which may cause irreversible loss of fertility.
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Before removal of the ovary(ies) for benign tumors
or endometriosis.
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Women with a family history of premature ovarian failure
or premature menopause may select to preserve their fertility at a younger
age. Some forms of early menopause (premature ovarian failure) are
genetically linked. Fertility Preservation offers a chance to preserve eggs
before they are depleted.
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To defer reproductive aging. Fertility
preservation is an option for women who want or need to delay childbearing
in order to pursue educational, career or other personal goals. Because
fertility is scientifically proven to be age-dependent, freezing your eggs
at an early reproductive age may improve your chance for a future pregnancy
and decrease the incidence of birth defects associated with aged oocytes.
Technologies for Female Fertility Preservation Include:
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Embryo freezing: Eggs are matured with the use of
injectable hormones, removed, fertilized in vitro (outside the body) with
sperm, frozen and stored. Embryo freezing is frequently used in regular IVF
for extra non-transferred embryos. Embryo freezing has been performed
successfully since the 1980s. Thousands of babies have been born using this
technology and there is a large body of data confirming its safety. Embryos
can be frozen at different stages of development using various freezing
techniques. The survival of the embryos after the freezing and thawing is
high, making embryo freezing an excellent option for Fertility Preservation.
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Egg freezing: Multiple eggs are matured with the use of
injectable hormones, removed, frozen, and stored without being fertilized.
Egg freezing
is an option for patients without a partner who do not want to use donated
sperm. For many years it was possible to freeze and preserve sperm and
embryos, but the preservation of eggs was difficult due to the sensitivity
of the egg to the freezing/thawing process. Recent improvements in oocyte
cryopreservation (egg freezing), particularly the use of a special freezing
methodology called vitrification has resulted in increased success.
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Ovarian tissue cryopreservation: Ovarian tissue freezing is
sometimes done in patients who are having abdominal surgery or when it is
not advisable to stimulate the ovaries to obtain embryos or eggs for
freezing.
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Ovarian suppression: Medications are administered during
cancer treatment to protect the ovaries and reduce the risk of infertility.
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Ovarian transposition: Surgically displacing the ovaries
prior to radiation therapy to minimize damage.