What is fertility preservation?
Fertility preservation means freezing oocytes (eggs), sperm, or embryos for use at a later time. It should be considered prior to treatment for cancer or rheumatologic disease that might damage a person’s ability to have children later. Often such treatment delays childbearing for years so it may make sense to save gametes (oocytes and sperm) or embryos when a person is young for use when he or she is older.
In fact, if there is likely to be a significant delay to pregnancy for any reason, such as school, work, or military service, fertility preservation can provide peace of mind. The ability to become pregnant declines with age, so having frozen oocytes may allow women to pursue their career and life goals first with the opportunity for a pregnancy later when it might otherwise not be possible.
What is the process of fertility preservation?
In order to cryopreserve (freeze) oocytes, a woman takes medication for about two weeks. The oocytes are then cryopreserved in a process called vitrification. These oocytes can be fertilized at a later time, often several years later. The cryopreserved oocytes do not age. This means that a 28-year-old woman who freezes her oocytes and uses them 10 years later is as likely to get pregnant at 38 years old as she was at 28 years old! Oocyte cryopreservation is a great option for a young woman who does not have a partner yet but wants to take steps to preserve her fertility so that she can become pregnant later.
If a woman does have a partner, the oocytes can be fertilized at the time they are removed to create embryos to be frozen. When pregnancy is desired, the embryos are thawed and placed into the woman’s uterus. If she is not able to carry the pregnancy herself, the embryos can be transferred into a gestational carrier, a woman who is willing to carry the pregnancy for the intended parents.
When a man faces cancer treatment, military deployment, or just wants to safeguard his fertility, he can freeze semen samples. These frozen sperm samples can be used years later for intrauterine insemination (IUI) or in vitro fertilization (IVF). Pregnancies have been reported almost 20 years after embryo cryopreservation and over 40 years later when frozen sperm was used!
How does one start the process of fertility preservation?
A consultation with a reproductive endocrinology/infertility specialist is essential. This specialist will prescribe the fertility medications, retrieve the oocytes from the ovaries, and store the frozen gametes or embryos. When pregnancy is desired, he or she will provide the treatment to use the frozen sperm, thaw the oocytes to fertilize them, or transfer the frozen embryos into the uterus.