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Fertility preservation involves freezing and storing eggs, sperm, or embryos. Techniques for preserving fertility offer women the choice of when to become a mother. These treatments can also be used to ensure patients are able to have children after completing treatments for cancer that may affect their fertility.
- Patients who want to postpone having a child for social reasons, for women that would like to preserve their eggs for use in the future, providing more flexibility around their own fertility decisions.
- Patients at risk of losing their ovarian function: for example women who have cancer and are going to be treated with chemotherapy or radiotherapy, autoimmune diseases which require chemotherapy, bone marrow transplants, and women who may need repeated ovarian surgery, for example, to treat endometriosis.
In 26 years, the IVI Group has helped more than 160,000 dreams come true.
97% of our patients said they would recommend IVI. We work with you at every stage of the treatment, providing support and care.
IVI has a worldwide reputation for innovative research and has developed and patented pioneering techniques and technologies.
IVI is one of the largest fertility providers in the world, with over 70 clinics in 13 countries.
Techniques for preserving fertility at IVI
The following preservation techniques are offered by IVI:
Mature eggs obtained following ovarian stimulation are cryopreserved using vitrification so that they can be used at a later date. This technique preserves fertility so effectively that eggs have the same likelihood of resulting in a successful pregnancy after vitrification as they did before they were frozen. This is achieved by using a vitrification process that involves a very rapid drop in temperature to prevent ice crystals from forming during the freezing process.
Freezing of the ovarian cortex
Cryopreservation of the ovarian cortex has resulted in successful pregnancies in some countries. This technique helps restore ovarian function so that babies can be conceived naturally or using assisted reproduction techniques. Another benefit is that it restores normal hormone levels and so helps avoid the secondary effects of early menopause (for example osteoporosis, hot flushes and cardiovascular problems).
This can be useful for:
- Cancer patients who need chemotherapy or radiotherapy immediately and do not have time for ovarian stimulation.
- Girls who need cancer treatment and who have not yet reached puberty. This technique can also be used in conjunction with the vitrification of oocytes if appropriate.
- Patients for whom ovarian stimulation might be contra-indicated.
Preservation of fertility at IVI: cancer patients
Ovarian function and preserving fertility are two of the aspects which most concern female cancer patients. Preserving your fertility when you are fighting cancer can help you maintain and enhance your self-esteem.
Improvements in treatments and screening programmes mean that more and more people are overcoming cancer. This increased survival rate has led to a greater focus on the secondary effects of treatments using chemotherapy and radiotherapy.
We at IVI have worked hard to find ways to offer cancer survivors options for preserving their fertility so that when they are well enough, the option of having a baby is still there for them.
As part of our commitment to help cancer patients, in December 2015 IVI donated £250,000 to the Oxford University Hospital Trust to fund a service to preserve the fertility of children with cancer. The IVI Foundation is also working with Oxford University on the basic science around the return of fertility to young people who have been treated for cancer.
The effects of cancer on fertility:
- The ovarian cortex contains a set number of follicles, which are gradually lost throughout a woman’s life. Radiotherapy and chemotherapy speed up the natural reduction in the number of follicles and prevent them from maturing. This, together with the fact that ovaries cannot regenerate, can lead to premature ovarian failure.
- The number of primordial follicles which survive following exposure to chemotherapy depends on many different factors such as age, the type of cancer, the agent used (chemotherapy or radiotherapy), the dosage and the number of cycles.
- Not everybody will lose their reproductive capacity following treatment. However, even people whose ovarian function is restored may find that the quality of their eggs is compromised.
- Pregnant women who had cancer during childhood experience a higher rate of miscarriage, a greater incidence of intrauterine growth retardation and a greater risk of premature births.
- Premature ovarian failure can also lead in the longer term to bone and cardiovascular problems as a result of the ending of hormonal functions.
There are currently several different options and treatments available to cancer patients to help maintain their fertility:
- Vitrification of ovocytes
- Freezing of the ovarian tissue
- Transposition of the ovaries
- Medical protection of the gonads (GnRH agonists): this could prevent follicles from reaching their sensitivity threshold to chemotherapy by suppressing granulosa cells. The protective effect of GnRH-a may not be sufficient in the case of more prolonged treatments and higher doses of chemotherapy.
Although its use is controversial, the most recent randomised studies seem to indicate some beneficial effects.
- In vitro maturation of oocytes (IVM): this consists of recovering immature oocytes from small antral follicles which have not been stimulated or which have only been minimally stimulated, and their cultivation in a suitable medium until they reach maturity. In this way it is possible to avoid ovarian stimulation, and as a result it is a potential alternative to a standard IVF cycle. It may be useful in patients for whom, for one reason or another, ovarian stimulation is contra-indicated, such as patients with hormone-dependent tumours. IVM should be considered as a complementary technique to ovarian stimulation, for use in cases where there is no time to carry out ovarian stimulation, or when immature oocytes are obtained following stimulation.
These treatments aiming to preserve the fertility of cancer patients cannot guarantee a future pregnancy, but they do mean that it is possible to try.