There are many things we can do prior to a patient’s therapy in order to preserve fertility.

In Vitro Fertilization (IVF) & Embryo Banking

IVF and embryo banking are excellent options for:

– Women who do not have a male partner, are not interested in using donor sperm, or do not desire to bank embryos.
– Women who can safely delay cancer treatment for 2-6 weeks.

IVF and embryo banking involves stimulating the ovaries to produce multiple eggs, combining eggs with sperm in the laboratory and freezing the embryos that result. IVF and embryo banking occur over 2-6 weeks. Embryos are implanted at a later date after cancer treatment and recovery have been completed.

Embryo banking is the most established form of fertility preservation and is a wonderful option for women who have a male partner or are interested in using donor sperm. For breast cancer patients, there are specific ovarian stimulation protocols that may be considered to reduce exposure to estrogen.

Egg Banking

Egg banking is recommended for:

– Women who do not have a male partner or are not interested in using donor sperm.
– Women who can safely delay cancer treatment for 2-6 weeks.

Egg, or oocyte, banking is similar to embryo banking because it involves the same stimulation of the ovaries to produce multiple eggs. These eggs are retrieved from the ovaries and are then frozen without being fertilized by sperm. Eggs would be fertilized at a later date and the resulting embryos would be implanted after cancer treatment and recovery have been completed.

In recent years, significant advances in freezing eggs have occurred. Through a cryopreservation technique called vitrification, egg survival after freezing, fertilization and subsequent pregnancy rates have increased. Some early clinical experiences suggest that egg banking may have similar success to embryo banking, but the experience across the country is limited. Therefore, egg banking is an option for patients, but it is still too early to say that the success rate is as high as banking embryos.

Ovarian Tissue Banking

Ovarian tissue banking is often used when patients do not wish to or cannot safely delay cancer treatment to undergo embryo or egg banking.

For ovarian tissue banking, one ovary is removed through a minor surgical procedure called laparoscopy. The outer surface (cortex) of the ovary, which contains the eggs, is frozen in strips for later use. Women who are survivors of some types of cancer can have pieces of the tissue thawed and transplanted back. A number of pregnancies have resulted from using this technique. Transplant is not safe following some types of cancer (e.g. leukemia) because of the risk of re-seeding the original cancer. We are partnered with the national Oncofertility Consortium®, an NIH-funded program that is actively researching new ways to use this tissue. This option is experimental but may be the best option for woman who must start their treatments immediately.

Fertility Sparing Surgery

Fertility sparing surgery is often the best choice for:

– Women who will be exposed to abdominal or pelvic irradiation
– Women with early stage cervical cancer

There are several types of fertility sparing surgeries. For patients who will receive abdominal or pelvic irradiation, it may possible to move the ovaries surgically out of the field of radiation (ovarian transposition). For patients with early stage cervical or ovarian cancer, experienced gynecologic oncologists may be able to conserve reproductive organs at the time of cancer surgery.

Component: Video Embed Block

Meet Dr. Su, RPSD’s Director of Fertility Preservation