Highlights From the 2015 Meeting of the American Society For Reproductive Medicine - FERTILITY PRESERVATION

Fertility Preservation South Jersey

FERTILITY PRESERVATION

 

Concerning fertility preservation, it was clear that many women are diagnosed and treated for

cancer during their reproductive years without adequate access to methods of fertility

preservation. Many cancer surgeons and oncologists are poorly educated about the choices

available for women facing cancer treatments that may prevent or permanently reduce their

chances of a future pregnancy. The two readily available options include egg freezing, and

ovarian tissue freezing. Clearly, egg freezing is the more popular and commonly used approach

since fairly recent technological advances have made this option highly successful. Until

several years ago, successful egg freezing had proven elusive because of the delicate spindle

fibers contained within the cytoplasm of the egg. However, advances in egg freezing technology

has made this procedure quite successful at this time with excellent survival rates. There is also

some misunderstanding among health professionals as to how much time is necessary in order

to put a patient through the process of egg procurement. In these situations, there is an

urgency to get started with whatever the planned cancer treatment may be. Patients and their

families are understandably stressed and are getting a lot of complex information. Referral to a

reproductive specialist may seem a low priority and is often neglected for fear that this may lead

to delays in treatment. The presenters at this meeting made it clear that the entire process of

stimulation the ovaries and removal/freezing of eggs be accomplished within two weeks,

regardless of where the woman may be in her menstrual cycle. Although egg freezing is

becoming more common, it was pointed out that there have only been about 1000 babies born

from frozen thawed eggs. Thus far there does not appear to be any risks to the fetus

associated with egg freezing.

One question that is not completely answered at thistle is: How many frozen eggs are required

to achieve a single successful pregnancy? Of course, the answer to this question depends

heavily on the age of the patient at the time the egg retrieval is done. Younger patients will

clearly be more likely to conceive with fewer eggs, approximately 8-10, while older women will

require a greater number of eggs, probably around 15-20.

The alternative option to egg freezing for cancer patients is ovarian tissue freezing. With this

technology, the patient undergoes a minimally invasive surgical procedure in which a substantial

volume of ovarian cortex is surgically removed, cut into small strips, then frozen for future use.

When the patient is ready for child-bearing, the cryopreserved tissue is thawed and transplanted

to the ovary or another suitable location. Although this technique is used much less frequently

than egg freezing, it is effective and is a viable alternative for selected patients. The main

advantage of this technique is that once the tissue is transplanted, patients my conceive without

the use of In-Vitro fertilization. One of the disadvantages of this technique is that the

transplanted ovarian tissue graft may only function for a limited period of time.

 

Voorhees, New Jersey

Dr. Louis R. Manara

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