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:
- 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.
- Before treatment for autoimmune or benign systemic disease which may cause irreversible loss of fertility.
- Before removal of the ovary(ies) for benign tumors or endometriosis.
- 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.
- 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:
- 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.
- 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.
- 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.
- Ovarian suppression: Medications are administered during cancer treatment to protect the ovaries and reduce the risk of infertility.
- Ovarian transposition: Surgically displacing the ovaries prior to radiation therapy to minimize damage.