Fertility preservation options – for females

This page explains some of the fertility preservation options available to you before you start treatment.

 

Find out your risk

Your doctor of another member of your treatment team should tell you about any risks to your future fertility when they discuss your treatment options with you. If they haven’t yet, tell them you want to know.

Below is a list of questions you might ask:

  • What are the risks of infertility with my treatment plan?
  • What can I do to preserve my fertility?
  • How much time do I have before I start treatment?
  • What happens if I delay treatment to stimulate eggs for collection?
  • What can I do during treatment to protect my fertility?
  • After my treatment is over, how long could it take for my periods to start again?
  • Who do I need to talk to about my fertility options?
  • Can you refer me to a fertility clinic?
  • How do I know if I will be fertile after treatment?

 

Fertility preservation options

This page has information about commonly-used interventions to preserve fertility for people having cancer treatment. These are:

  • Egg collecting and freezing
  • Embryo development and freezing
  • Ovarian tissue freezing (ovarian cortex cryopreservation)
  • Ovary transposition (oophropexy)
  • Radiation shielding
  • Ovarian function suppression using hormone therapies (GnRH analogues)

Not all of these options may be available or right for you. You need to talk to your doctor about what is appropriate and will suit your personal needs.

 

Egg collecting and freezing

The aim of egg collection or harvesting is to collect mature eggs that can be frozen (called cryopreservation) and used at a later date. The process of collecting and freezing eggs takes about 10-14 days of hormone stimulation (through hormone injections). Eggs are collected through the vagina under ultrasound guidance.

Collection of immature eggs is a technique that is still in the experimental stages of development. Undeveloped or immature eggs may be collected and then matured (called in vitro maturation) in the laboratory and then frozen.

The process is a bit different from collecting mature eggs as you don’t need to have the same amount of injections prior to the collection of the eggs. Having the hormone injections is what matures the eggs, therefore without these injections the eggs remain immature.

How long can I freeze my eggs or an embryo?
As far as we know, you are able to freeze your eggs and/or an embryo for as long as needed until you decide to have a child.

 

Embryo development and freezing

The process for developing and freezing embryos is quite similar to that of egg collecting and freezing – with one additional step. An embryo is a fertilised egg, so you need sperm in order to create an embryo (i.e. a man).

Embryo freezing is a very successful form of treatment, however it is going to be less of an option for you the younger you are. This is because you are probably less likely to have a serious boyfriend or partner – or you might have a boyfriend but you’re not really sure if you want to have children with him in the future.

 

Ovarian tissue freezing (ovarian cortex cryopreservation)

Taking a slice of your ovary and freezing it for the future is a technique that is very new and still quite experimental.

It involves a small operation (called a laparoscopy) under a general anaesthetic to remove a slice from the outer part of an ovary. There are many immature eggs in this part of the ovary, which is then frozen.

Once you have completed your cancer treatment the ovarian slices may be transplanted back into your abdomen. The hope is that your ovary will start to function normally again.

 

Ovary transposition (oophropexy)

Ovarian transposition is the surgical movement of one or both of your ovaries to another area in the body so that they are out of the field of radiation (normally 3cm from the upper radiation field).

This is usually done for women who are having pelvic radiation. It does not protect your ovaries against the effects of chemotherapy.

 

Radiation shielding

If the ovaries are close to where the radiation is directed (but they are not the target for radiation), then the ovaries can be shielded from the radiation beams by using protective coverings.

This technique does not guarantee that radiation will not affect your ovaries but it does provide some level of protection. Your doctor may still suggest undergoing ovarian transposition.

 

Ovarian function suppression using hormone therapies (GnRH analogues)

A method that might be offered to you to protect your fertility during treatment is the use of hormone therapy to slow down and stop the function of the ovaries.

This method protects your ovaries during chemo as the hormones essentially cause a temporary shutdown of your ovaries, known as temporary menopause.

This method is also considered to be quite new and experimental, however early research has shown that GnRH analogues may reduce the risk of permanent ovarian failure by up to 40%.