Fertility preservation is the process of saving or protecting eggs, sperm, or reproductive tissue so that a person can use them to have biological children in the future.
Indications For Fertility Preservation:
- Patients diagnosed with cancer who are due for radiation therapy or chemotherapy
- Social freezing where pregnancy is delayed for personal or professional reasons
- Patients with medical disorders delaying pregnancy
Fertility-preserving options for males include:
- Sperm cryopreservation: In this process, a male provides samples of his semen. The semen is then frozen and stored for future use in a process called cryopreservation.
- Gonadal shielding. Radiation treatment for cancer and other conditions can harm fertility, especially if it is used in the pelvic area. Some radiation treatments use modern techniques to aim the rays on a very small area. The testicles can also be protected with a lead shield.
Fertility-preserving options for females include:
Embryo cryopreservation
This method, also called embryo freezing, is the most common and successful option for preserving a female’s fertility. First, a health care provider removes eggs from the ovaries. The eggs are then fertilized with sperm from her partner or a donor in a lab in a process called in vitro fertilization. The resulting embryos are frozen and stored for future use.
Oocyte cryopreservation
This option is similar to embryo cryopreservation, except that unfertilized eggs are frozen and stored. Suitable for unmarried women or those without partners.
Gonadal shielding.
This process is similar to gonadal shielding for males. Steps are taken, such as aiming rays at a small area or covering the pelvic area with a lead shield, to protect the ovaries from radiation.
Ovarian transposition
A health care provider performs a minor surgery to move the ovaries and sometimes the fallopian tubes from the area that will receive radiation to an area that will not receive radiation. For example, they may be relocated to an area of the abdomen wall that will not receive radiation.
Ovarian tissue cryopreservation
The procedure is to take a part of the ovary and carry out slow freezing before storing it in liquid nitrogen. Tissue can then be thawed and implanted near the fallopian tube, either orthotopic (on the natural location) or heterotopic (on the abdominal wall), where it starts to produce new eggs, allowing normal conception to take place.
Some of these options, such as sperm, oocyte, and embryo cryopreservation, are available only to males and females who have gone through puberty and have mature sperm and eggs. However, gonadal shielding, ovarian transposition and ovarian tissue cryopreservation can be used to preserve fertility in children who have not gone through puberty.