Patients may wish to preserve fertility for several reasons
- To delay child-bearing
- To allow treatment of a medical condition which may affect future fertility
- To allow storage of eggs, sperm or embryos prior to cancer treatment
For male patients
Freezing sperm is the most effective way of preserving fertility. This can be done on more than one occasion if time permits.
For female patients
Egg freezing and embryo freezing
Both of these techniques require a process similar to IVF treatment. Recent advances mean that shorter protocols may require approximately 10 days to 2 weeks from the time of your period to collecting eggs. The eggs collected may then be frozen directly (vitrification) or alternatively fertilised with a partner’s or donor sperm before freezing (embryo freezing).
Over the last decade the method used to freeze eggs has changed. The use of the old ‘slow freezing’ technique had been associated with rather poor post-thaw survival rate, fertilisation rate and consequently – pregnancy rate. The new ‘vitrification’ technique has been proven to result in similar fertilisation and embryo development to what is achieved in IVF-ICSI cycles with fresh eggs. Hence, it is believed that vitrified eggs are ‘suspended in time’ at the age they are frozen. This way women who freeze their eggs can effectively reduce the age-related (or medical condition related) drop in their fertility. When faced with difficulty conceiving at a later age, they may opt to use their frozen eggs to give them the same chance of a live birth that they had at the point of egg freezing.
Egg vitrification is fairly new and the vast majority of vitifrified eggs still remain in storage. Only a minority of women have reached a point by which they had the eggs thawed to fulfil their fertility wish. Hence, the relatively small number of reported live births associated with this technique. Yet, the data derived from small studies suggests promising pregnancy and live birth rates.
We will discuss these treatment options with you at your consultation in more detail. (If appropriate we may also need close communication with your oncology team before embarking upon any treatment to ensure that we do not in any way lessen the chances of your cancer treatment being successful).
Ovarian tissue freezing
Several small strips from the outside of one of the ovaries are removed by laparoscopy (key-hole surgery). This tissue containing immature eggs is then frozen until a suitable time after which it may be transplanted back (grafted) on to the ovary. This is an experimental procedure with a few reported livebirths.
This form of treatment may be considered for those patients who need to commence cancer treatments without delay and may also be suitable for those patients for whom IVF carries other risks.
IVF Hammersmith holds close links with gynaecological surgical oncologists, specialists in the surgical treatment of cancers of the female reproductive system. Standard surgical treatments may lead to loss of fertility but in some carefully selected cases a more conservative approach may be possible preserving future fertility.)
Egg donation and surrogacy
For those patients who may not want to consider or who are not suitable for the above options then egg donation, surrogacy or adoption may be options for having a child in the future.