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.
