“Preserving Fertility Options During Cancer Treatment: Oncofertility”
For individuals recently diagnosed with cancer, time is often a critical factor in their cancer care plan. Moreover, life-saving cancer treatments like chemotherapy and radiation can significantly jeopardize a patient’s fertility, impacting their ability to have biological children later in life. Both the quantity and quality of eggs and sperm can be compromised by these treatments. Consequently, those seeking fertility preservation alongside cancer treatment often need to commence treatment shortly after diagnosis.
Fertility Preservation through Cryopreservation The field of medicine that addresses reproductive concerns in patients with cancer is known as oncofertility. One vital strategy within oncofertility is the preservation of reproductive tissues before exposure to radiation, chemotherapy, or surgery intended to remove such tissues. The most common method employed for this purpose is cryopreservation and vitrification, which involves treating tissues with cryoprotective agents and rapidly freezing them at extremely low temperatures. These cryoprotective agents help maintain tissue stability during freezing and thawing.
Oncofertility & Fertility Preservation for Female Patients Fertility preservation for female patients primarily involves egg freezing. In this process, the initial steps resemble traditional in vitro fertilization (IVF). Patients self-administer fertility medications to stimulate ovarian growth and induce the maturation of multiple eggs simultaneously. Throughout this phase, the patient’s ovaries are closely monitored for egg development. Once the eggs are deemed mature, the patient undergoes an egg retrieval procedure, which is relatively swift. During this procedure, eggs are collected directly from ovarian follicles using an aspiration needle. Subsequently, these eggs are frozen and stored for future use.
This comprehensive process can span several weeks, potentially affecting the patient’s cancer treatment timeline. Therefore, it is imperative for female patients to initiate discussions about fertility preservation with their oncology team as early as possible during their cancer care planning.
Oncofertility & Fertility Preservation for Male Patients Fertility preservation for male patients mainly involves sperm freezing, which is a relatively straightforward process that can be swiftly completed. It seldom necessitates delaying cancer treatment.
In sperm freezing, male patients provide a semen sample, typically through masturbation. To ensure the sample contains robust, healthy sperm, patients are advised to abstain from ejaculation for two to three days before collection. This sample can be provided at the clinic or at home, but if done at home, it should be delivered to the clinic within 1-2 hours of ejaculation to ensure optimal sperm viability. In the laboratory, sperm are placed in a freezing solution and frozen in small vials.
Embryo Freezing For individuals in committed relationships or those with a defined genetic plan for future offspring, embryo freezing represents a preferred option over both egg and sperm freezing. Embryo freezing involves freezing a developed embryo rather than separate gametes (sperm and egg). This process entails creating embryos via IVF, where sperm and eggs are collected from the patient, their partner, or a donor, and combined in a laboratory. After fertilization, embryos develop and are then frozen using vitrification technology, similar to egg and sperm freezing. These frozen embryos can be stored indefinitely until the patient is ready to proceed with fertility treatments.