Fertility
Preservation of Fertility in females
Therapy Modifications:
Moving the ovaries out of the RT field prior to therapy called (ovariopexy or oophoropexy).
The ovaries can be moved laterally, toward the iliac crest, or behind the uterus.
This reduces the dose of RT to the ovaries and helps to preserve fertility.
This method is appropriate for adult patients.
In vitro fertilization (IVF): oocytes are fertilized with sperm (from an adult patient's partner or a donor) in a lab. The embryos created are then frozen.
IVF and embryo freezing are performed prior to chemotherapy or radiation therapy.
Embryo freezing takes approximately two weeks after the onset of the patient's period. Depending on the menstrual cycle, this may require a two to four week delay of the cancer treatment.
However, a partner is required for a fertilized egg so this method is not practical for pediatric patients
Oocyte Cryopreservation (after hormone stimulation)
Oocytes are removed after 10 to 12 days of hormone injections. The unfertilized oocytes are then frozen for future use.
This procedure can delay cancer treatment.
The success of oocyte freezing is less than embryo freezing
Cryopreservation of ovarian tissue (ovarian cortical strips).
Cryopreservation of ovarian tissue and in vitro follicle maturation are two emerging techniques for fertility preservation, especially in cancer patients.
Part or all of the ovary is removed surgically under general anesthetic.
No hormone stimulation is needed.
The tissue that is removed is divided into thin strips which contain immature oocytes. The tissue is then frozen and stored for future use.
Suitable for prepubertal girls.
Disadvantages:
- There is a risk of damage to the ovary
- Risk of transplanting malignant tissue
- The success rates of ovarian tissue freezing is too early to evaluate as this technique is very new and really experimental. Fewer than 10 babies have been born worldwide using this technique.
Resources:
Female fertility preservation at the Genesis Fertility Clinic
