The option to preserve one’s fertility be it for personal or medical reasons gives women the freedom to choose motherhood only when they are ready for it without the pressure of their biological clock. Advances in fertility preservation techniques mean that women today have a wider range of choices to address their specific needs. The risk of infertility or premature ovarian insufficiency are just a couple of reasons for women opting to preserve fertility. In some women menopause may start before they reach the age of 40 because of genetic reasons. Fertility Preservation can help women who intend to delay their maternity beyond the age of 35, or who are forced to do so for work or financial reasons or when a woman must undergo chemotherapy or radiotherapy. These treatments can cause damage to the ovarian follicles and reduce reproductive capacity. An invasive ovarian surgery may lead to reduced fertility. Women with diminished ovarian reserve or genetic alterations that could decrease ovarian reserve in a few years also opt for fertility preservation.
There are several different ways to preserve fertility: frozen embryos, frozen eggs, and frozen ovarian tissue. The earliest method of fertility preservation made use of previously frozen embryos, which are implanted later in a similar way as in vitro fertilization. Fertility Preservation is not just for women. Men also can take steps to preserve their fertility before undergoing cancer treatment. Sperm cryopreservation that involves freezing and storing sperm at a fertility clinic or sperm bank for use at a later date and Radiation shielding when small lead shields are placed over the testicles to reduce the amount of radiation exposure are some methods men opt for.
Let’s look at some of the Fertility Preservation techniques available for women.
- Embryo cryopreservation that involves harvesting eggs, fertilizing them and freezing them so they can be implanted later. During ovarian tissue cryopreservation, small pieces of ovarian tissue — or, in some cases, the entire ovary — are frozen and then re-implanted. Transplanted ovarian tissue can be active for more than 7 years.
- Egg freezing (oocyte cryopreservation) is a procedure where the unfertilized eggs are harvested and frozen. Human eggs don’t survive freezing as well as human embryos.
- The Ovarian transposition (oophoropexy) procedure involves the ovaries being surgically repositioned in the pelvis so they’re out of the radiation field when radiation is delivered to the pelvic area. However, because of scatter radiation, ovaries aren’t always protected. After treatment, the ovaries are repositioned again to conceive.
- To treat early-stage cervical cancer, a large cone-shaped section of the cervix, including the cancerous area, can be removed (cervical conization). The remainder of the cervix and the uterus are preserved.
During a fertility preservation procedure, subcutaneous injections of hormones are administered for ovarian stimulation. In a natural cycle, a woman produces a single egg. With ovarian stimulation the aim is to get several eggs, at least 10 to have a better chance of achieving an embryo to achieve a future pregnancy. Ten or twelve days after the treatment, the extraction of the eggs is carried out by egg collection. The extracted eggs are treated with cryoprotective substances that will prevent ice crystals from forming in their structure, which could damage them. Vitrification is a process of ultrafast freezing using liquid nitrogen. This process allows the patients’ eggs to be preserved indefinitely, keeping their properties intact for use in IVF treatment.
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