Fertility preservation helps cancer patients or survivors avoid infertility which may result from to chemotherapy, radiation therapy, and/or surgical treatment. Also, patients with certain non-cancerous conditions including ovarian cysts, family history of early menopause, and lupus can benefit from fertility preservation. Other women at risk of losing ovarian function at young ages due to genetic causes, or women concerned about loss of eggs and fertility due to natural aging also are candidates.
Elective Fertility Preservation
Women at risk of losing ovarian function at young ages due to genetic causes, or women concerned about loss of eggs and fertility due to natural aging, or women who must delay pregnancy for medical or social reasons are candidates for elective oocyte or embryo freezing. Best results are achieved for women under age 35.
Fertility and Cancer Patients/Survivors
Patients facing cancer treatment with either radiation to the pelvic area, or total body irradiation, or chemotherapy using drugs called alkylating agents, such as cyclophosphamide (cytoxan), may be at high risk of undergoing premature menopause. In some cases doses of chemotherapy are not high enough to cause premature menopause, but will often result in the loss of eggs from the ovaries, which can lead to difficulty in conceiving and infertility.
The Center for Infertility and Reproductive Surgery is one of the few centers in the world that offers specific evaluation and therapy for women undergoing chemotherapy and radiation therapy. Our specialized services include options to preserve fertility before undergoing chemotherapy, surgery to move ovaries out of the radiation field, assisted reproductive technologies prior to cancer treatment such as egg and embryo freezing prior to cancer treatment, as well as evaluation and treatment of cancer survivors who are experiencing infertility.
Fertility Preservation for Cancer Patients Undergoing Chemotherapy/Radiation
- Egg Freezing
Women can freeze eggs before undergoing cancer treatment. The first step involves taking injections of fertility medications for about two weeks to stimulate production of eggs, a process called ovarian stimulation. Once tests indicate that eggs have developed in the ovaries, the eggs are surgically removed by a fertility specialist using an ultrasound guided needle, under light anesthesia to avoid pain. Pregnancy and live birth rates using frozen eggs are excellent. As a result, the American Society of Reproductive Medicine no longer considers the procedure experimental. We have a well-established, tested program of egg freezing.
- Embryo Freezing
Eggs collected by ovarian stimulation may also be fertilized by sperm (from the male partner or a sperm donor, using in vitro fertilization, and frozen for future use. The use of frozen embryos is a well established fertility treatment with proven pregnancy rates. It takes approximately two weeks to undergo the ovarian stimulation for an in-vitro fertilization treatment, but shorter course treatment is sometimes possible.
- Ovarian Tissue Replacement
For women who have a rapidly progressing cancer or don’t have time to undergo ovarian stimulation, ovarian tissue can be removed and replaced in the abdomen after cancer treatment ends. This treatment will reverse menopause if it occurs as a result of chemotherapy. The replaced ovarian tissue typically functions for three to eight years. Women have become pregnant naturally after ovarian tissue replacement or using IVF treatment. Ovarian tissue replacement is also an option for girls who have not yet reached puberty but who are at high risk of being sterilized by cancer treatment. After puberty, some girls and women choose to do both ovarian stimulation with egg freezing and ovarian tissue freezing.
- Leuprolide Acetate
The use of leuprolide acetate (lupron) to suppress ovarian function prior to and during chemotherapy may reduce the likelihood of losing eggs and undergoing menopause due to chemotherapy. However, findings supporting the use of lupron are not consistent in published randomized trials.
Fertility Treatments for Cancer Patients After Reproductive Surgery
Women who have had a hysterectomy but still have their ovaries can have children through the use of in-vitro fertilization technology and a gestational carrier. The eggs of a woman are fertilized outside her body through the use of in-vitro fertilization, and the resulting embryos placed into the uterus of another woman, or gestational carrier, who will carry the pregnancy for the intended parent(s). This treatment is not medically complicated, but a great deal of counseling as well as testing is required to make sure the experience goes well for all involved.
For women who undergo removal of both ovaries, but retain their uterus, the use of donor eggs which are fertilized outside the body and then replaced into her uterus can be performed. This treatment is not medically complicated, but a great deal of counseling as well as testing is required to make sure the experience goes well for all involved.
This page was last modified on 10/29/2014