The survival rate of cancer patients has improved markedly over the past several decades. Cancer treatments, including surgery, chemotherapy or radiation, may leave the patient sterile or with reduced fertility. With advancements in laboratory freezing techniques, we are now able to freeze reproductive tissue prior to the start of potentially damaging cancer treatment.
The most successful technique to preserve fertility in women with cancer is embryo freezing. This requires performing an in vitro fertilization (IVF) cycle. Eggs are harvested from the woman, fertilized in the laboratory with her husband’s sperm and the resulting embryos frozen. Once her cancer treatment has been completed and she is free of disease, the frozen embryos can be thawed and transferred into her uterus.
Women who are not married and do not have a male partner are not candidates for embryo freezing. In these cases the woman undergoes ovarian stimulation and egg retrieval. A new freezing technique called vitrification allows the unfertilized eggs to be safely frozen in the unfertilized state. At a later time, the eggs are thawed and fertilized with the husband’s sperm to create embryos.
Men who have been diagnosed with cancer can freeze their sperm and store it for future use. This is a well-established and successful technique to preserve fertility in the male. If time permits, multiple sperm samples are collected and frozen prior to the start of cancer treatment. The frozen sperm can be used for artificial insemination or IVF at a later time.
Women with certain types of cancer may also benefit from suppressing their ovaries during cancer treatment. A pseudo-menopause state is created with a monthly injection of drug called leuprolide acetate (Lupron). Ovarian suppression during chemotherapy seems to, at least partially, protect the ovaries from the toxic effects of the cancer drugs.
The diagnosis of cancer is devastating and patients and their oncologists are anxious to start treatment as soon as possible. The above fertility preserving techniques can usually be performed in a timely manner so as not to delay the start of cancer treatment. We will work closely with your oncologist to ensure your cancer treatment is not compromised by fertility preserving therapy.
Women who do not have a male partner, and are concerned about their fertility potential in the future , may freeze their eggs for use at a later time. Ovarian hyperstimulation, similar to what is done for standard IVF, will be performed. The eggs will be retrieved by transvaginal aspiration under ultrasound guidance. Mature eggs will be frozen and stored in liquid nitrogen. In order to attempt pregnancy in the future, the eggs will need to be thawed and fertilized in the laboratory with intracytoplasmic sperm injection (ICSI) with your partner’s sperm. The resulting embryo(s) are then transferred back into your uterus. It is important to understand that freezing your eggs does not guarantee a successful pregnancy. It does allow for the possibility of a future pregnancy using eggs that were retrieved at your younger age. Finally, it should be noted that most women who have frozen their eggs, whether prior to cancer treatment or for social reasons, have not yet returned to use them. You have control and decision regarding final disposition of your eggs. They will remain frozen until you direct us what to do with them.
Visit reproductivefacts.org for information concerning female cancer, cryopreservation and fertility.