TYPES OF FERTILITY PRESERVATION

There are 2 types:

1. 1. Removing and freezing of eggs, embryos, sperms and tissues for future use.
   2. Minimizing the impact of cancer treatment on the reproductive tissue.

A number of fertility preserving options are available for both males and females.

FOR MALES:

• SPERM CRYOPRESERVATION: Sample of semen is frozen in sperm banks for future use by a process called cryopreservation.
• GONADAL SHIELDING: In case of cancer treatment where radiation is used (especially for pelvic area), gonads/ testicles can be protected using lead shield to prevent infertility. Also, modern techniques can be used so that radiation rays are aimed precisely on a very small area.
• TESTICULAR TISSUE FREEZING: In men who do not have sperms in semen or prior to puberty or in people Designated Male At Birth (DMAB), a sample of testicular tissue containing sperm is extracted and frozen for later use.

FOR FEMALES:

• EMBRYO CRYOPRESERVATION: Most commonly used method for fertility preservation that has high success rate. Egg of the female and sperm from her partner or donor are fertilized in the laboratory by IVF to form embryo. The resulting embryos are frozen and stored for future use.
• OOCYTE CRYOPRESERVATION: Here the egg/ ova itself is removed and frozen before fertilization for future use.
• OVARIAN TISSUE FREEZING: Here the ovarian tissue is extracted and frozen before starting cancer treatment and after you are medically cleared of cancer, it is re-implanted again.
• GONADAL SHIELDING: This process is similar to gonadal shielding in males where the ovaries are covered with led shield and rays are aimed at specific area to prevent infertility.
• OVARIAN TRANSPOSITION: In this case, a minor surgery is performed to move the ovaries and sometimes even the fallopian tube from the area of radiation to another area in the abdomen that is away from radiation to prevent infertility from occurring.

Some of the options like sperm, oocyte or embryo cryopreservation are available only to males and females who have gone through puberty and have mature sperm and eggs. However, gonadal shielding and ovarian transposition can be used to preserve fertility in children who haven’t attained puberty yet.

ADVANTAGES OF FERTILITY PRESERVATION

By preserving egg/ oocyte/sperm, you might still be able to have a biological child despite your condition/ circumstance.

RISKS INVOLVED IN FERTILITY PRESERVATION

• • There might be slight bleeding or infection during retrieval of egg or sperm.
  • IVF can increase the risk of multiple births, premature delivery, low birth weight, miscarriage and ectopic pregnancy.
  • Laparoscopic procedure can cause infection, bleeding and injury to nearby organs and tissues. Anesthesia used in the procedure can cause nerve damage, medication reaction, post-operative delirium.
  • Ovarian stimulation may cause increase in estrogen levels leading to higher chances of blood clots, estrogen dependent cancers, ovarian hyperstimulation syndrome etc.
  • Ovarian transposition might lead to rotation of the relocated ovaries, development of ovarian cysts which might require removal of ovary (oophorectomy).

IDEAL TIME FOR FERTILITY PRESERVATION

It is best to start fertility preservation procedures as soon as possible. However, it is advisable to do fertility preservation –

• • Before starting cancer treatment
  • Before gender affirming treatment
  • By 35 years of age in women who have no immediate plans of having children.
  • After diagnosing of any disease that may affect fertility.

HOW LONG DOES FERTILITY PRESERVATION LAST:

You can preserve your egg or sperm indefinitely using advanced freezing methods without weakening them

Fertility preservation doesn’t guarantee pregnancy. The success of fertility preservation varies widely and depends on a variety of health and treatment related factors and help in increasing your chances of a successful pregnancy. Talk to your health care provider in making an informed decision and choose an approach that meets your needs.