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Fertility preservation (Oncofertility)
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Biology of women
For women, fertility irreversibly declines with age. Biology is inexorable and delaying pregnancy for too long can lead to infertility. For those women who, due to their life situation (e.g. lack of a partner or break-up of an existing relationship), do not actively try to have a child, but at the same time are aware of the role of age in the reproductive process and would like to have a child in the future, it is recommended to consider options to prevent future fertility problems.
If your only option for having offspring in the future is to freeze your ova, our fertility specialists can help.
Oncofertility
Not everyone knows that aggressive cancer treatment often irreversibly reduces fertility. In the literature, one often encounters the term "oncofertility," or fertility preservation or protection in oncology patients. This applies not only to female patients of childbearing age who must undergo oncological treatment, which may result in disruption or even termination of the reproductive process, but also to men suffering from testicular cancer, prostate cancer or lymphoma. In these cases, before the start of the therapy, it is also worth taking measures that will protect fertility, and after treatment will allow them to fulfil the dream of offspring.
Preservation of fertility in a woman
Cancer treatment (chemotherapy and radiotherapy) often leads to functional impairment of the ovaries. This is because the ovaries are particularly sensitive to the destructive effects of cytotoxic drugs. As a result, patients who have undergone oncological treatment, despite having overcome the disease, lose the chance to have biological offspring. The medical solution for such patients is to preserve fertility even before treatment begins.
At our TFP clinics in Poland, we use three medical procedures to restore fertility in women who have undergone cancer treatment. The choice of the appropriate method depends, among other things, on the patient's age, her current life situation and time constraints related to the oncological treatment.
Solutions for women
Embryo freezing
This method is used for patients who have a permanent partner. Couples who are trying to have a baby must undergo IVF preparation before their cancer treatment. Embryos (a combination of the woman's egg and her partner's sperm) are frozen and can be transferred into the woman's uterus after treatment. This method is not recommended when the patient's time for treatment is limited (when she should begin treatment immediately without wasting time on hormone stimulation) and in cases of cancer which preclude the use of hormone stimulation.
Freezing of mature oocytes
This method is used for patients of reproductive age but without a permanent partner. Only the woman's ova are frozen, so that they can be fertilized in vitro in the future after the completion of the cancer treatment. Time also remains a limitation of this method. If the patient should start the cancer treatment immediately, there is no time to undertake hormonal stimulation allowing for the collection of at least several mature ova. The method is also not used for cancers that preclude the use of hormonal stimulation.
Oocyte freezing is also the procedure of choice for patients wishing to secure fertility for reasons other than oncological disease.
Freezing of ovarian tissue
The method is distinguished by the fact that there are no time limits. It can be applied even in girls before puberty, in whom the ovaries have not yet started their activity. Thanks to the procedure healthy ovarian tissue can be implanted back into the patient after the cure of the cancer and after the sexual maturity of the patient. Thus, it allows restoring fertility to a woman whose ovarian function has been permanently damaged as a result of cancer treatment. The method of ovarian tissue freezing is also used in adult women who need to undertake oncological treatment immediately (they do not have time for hormonal stimulation) and in patients whose cancer excludes the use of hormonal stimulation. The method is considered experimental. The first child born to a woman in whom fertility was restored after freezing ovarian tissue was born in 2004.
What does ovarian tissue freezing treatment involve?
In a patient in whom immediate action is needed to preserve the chance of fertility (most often in patients with oncologic disease), an ovary or piece of ovary is harvested. The ovary is cut out laparoscopically and transported to the laboratory.
There, the cortical portion of the ovary (which is rich in ovarian follicles containing egg cells) is isolated and prepared. The prepared sections of ovarian cortex are frozen.
Once the patient's oncology treatment is complete and she has made the decision to become a mother, the harvested fragments are thawed and reimplanted into the ovary or extraperitoneally.
The reimplanted fragments take on hormonal activity within 3-4 months, and the process of oocyte maturation takes place within them. This makes fertilization and consequently pregnancy possible.
Some women who undergo the procedure become pregnant naturally, while others may need to use IVF technology.
It is worth noting that the implanted ovarian fragments take their function only for a certain period of time. Therefore, they are thawed only when the patient decides to have a child.
Fertility preservation in men
Cancer treatment often causes temporary or permanent impairment of fertility. This is because the gonads (testes) are particularly sensitive to the effects of cytotoxic drugs. To preserve fertility after cancer treatment, even before the start of chemotherapy, it is advisable to deposit sperm in a sperm bank, where it will be stored until the end of treatment and when the patient decides to have offspring of his own. Freezing semen is also recommended for patients preparing for urological procedures that may lead to loss of fertility.
It is also a good idea to use the sperm bank when planning treatment by insemination or in vitro fertilization in situations when there are difficulties with semen donation, extremely low semen parameters or when it is impossible to be present on the day of the insemination procedure.
How to freeze semen?
To deposit semen in our semen banks, you must come to the clinic prior to treatment for a semen examination (seminogram) and virological and bacteriological testing.
After receiving the test results, the patient donates the semen for freezing.
In the andrology lab, after adding the appropriate cryoprotectant, the semen is portioned into 0.5 ml straws, frozen, and stored safely in the bank.
The sperm frozen and stored in the bank, depending on the parameters, can be used for insemination or IVF/ICSI in vitro fertilization.
Don't let your fertility be irreversibly restricted. Modern medicine allows you to safeguard your fertility potential. Choose the clinic closest to your home and contact us today.
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