Fertility preservation: What are women’s options?
Prolonging your ability to have children is increasingly becoming a real option, whether you make this choice because of a cancer treatment, a different medical reason, or because you wish to delay having children until later in life.
Women consider fertility preservation for a number of medical and personal reasons, according to the National Institutes of Health (NIH) Eunice Kennedy Shriver National Institute of Child Health and Human Development.
If you are affected by cancer, the treatment you undergo may damage your ovaries, leaving you unable to have babies in the future. The same might hold true if you have been exposed to toxic chemicals in your workplace or during military service.
Preserving your reproductive tissues can allow you to delay childbearing in these instances.
But benign conditions can also affect your fertility. Non-cancerous tumors, endometriosis, or uterine fibroids can put you at risk of premature ovarian insufficiency, which means that your ovaries stop producing eggs, or oocytes, at an earlier age than they normally would.
This can also happen even if there is no clear link to such benign conditions. Your menopause may then start before you reach the age of 40, and genetic reasons are thought to be the root cause.
But the risk of infertility or premature ovarian insufficiency are not the only reasons why women consider fertility preservation.
"The largest group of women seeking fertility preservation," explains Dr. Jacques Donnez — a professor at the Société de Recherche pour l'Infertilité and Université Catholique de Louvain in Brussels, Belgium — "consists of those who wish to postpone childbearing for various personal reasons, the biggest threat to their fertility is age."
In an article published this week in The New England Journal of Medicine, Prof. Donnez explains the latest advances in the field and outlines which options are available for women to preserve their fertility.
How to preserve fertility
There are several different ways to preserve fertility: frozen embryos, frozen eggs, and frozen ovarian tissue.
The earliest method of fertility preservation made use of previously frozen embryos, which are implanted at a later date in a similar way to in vitro fertilization (IVF).
But one drawback of this technique is that a male partner or sperm donor is required to fertilize the woman's eggs to produce the embryos before they are frozen. In some cases, especially in young women and girls, this is not an option.
Next came the freezing of oocytes. Here, the eggs are frozen and then thawed at a later date. Once they are fertilized, the embryo can be implanted.
The first baby conceived using this method was born in 1986. However, the devil is in the detail; cells generally do not like to be frozen and are very susceptible to damage from ice crystals formed as a result of the freezing method.
A newer method of preserving oocytes is vitrification, which is very rapid freezing "in the absence of ice."
Speaking to Medical News Today, Prof. Donnez explained that the field has come a long way since the first IVF babies were born more than 40 years ago. These days, it is possible to obtain good-quality oocytes and preserve these through vitrification.
The key to success lies in the age of the woman undergoing the treatment, he...