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Fertility preservation


Women facing cancer treatment that could result in infertility may consider treatment to preserve their fertility. Cancer treatment could involve chemotherapy that damages eggs and reduces ovarian reserve; radiotherapy in the region of the ovaries that can damage eggs; or surgery to remove the ovaries or uterus.

Similarly, medical interventions such as chemotherapy, radiotherapy or surgery may temporarily or permanently affect sperm quality or result in sterility for men.

 

Fertility preservation for women

As the woman's oncology therapy is always first priority, these fertility preserving options may not always be appropriate or relevant.

IVF with embryo freezing

If a woman is in a stable relationship with a person who she would wish to have children with, IVF with a view to creating embryos to freeze might be appropriate. This will only be an option if the IVF treatment does not compromise or delay cancer treatment by an unacceptable amount of time. This is a decision your oncologist and your consultant at Fertility PLUS will discuss.

Egg freezing

Fertility clinics have been successfully freezing sperm and embryos for decades, but initially eggs had a much lower survival rate after slow freezing and thawing than embryos. However, in 2005 vitrification was introduced. Vitrification is a faster method of freezing eggs and the results are very similar to those for embryos.

The fertilisation rate may be a little lower for warmed eggs compared to fresh eggs, but the implantation of the embryos is expected to be very similar. Fertility PLUS now offers vitrification of eggs. Although this is a relatively new technique, it is being carried out in the laboratory by very experienced embryologists.

This procedure requires the woman to undergo an IVF cycle with the eggs frozen immediately following egg collection.

Gonadotrophin Releasing Hormone (GnRH) therapy

GnRH therapy might reduce the chance of damage to your eggs from chemotherapy although there is limited evidence showing any benefit from this therapy.

 

Fertility preservation for men

Semen cryopreservation prior to these treatments is an important option to consider for men who have not had children or whose family is not yet complete.

Sperm freezing

A sample can be produced and subsequently frozen and stored at a very low temperature in liquid nitrogen. If time allows, the patient may wish to freeze multiple samples prior to starting cancer treatment.

Testicular biopsy

If a patient is undergoing urgent surgery and/or he has not been able to produce a sample by masturbation for sperm freezing, it may be possible for the surgeon to remove a small piece of testicular tissue during surgery. This tissue can be processed by Fertility PLUS and can be frozen if sperm are found.

 

Referrals

For more information on referrals for fertility preservation: