Fertility preservation is a growing concern for cancer patients, especially women. Lack of implementation off the right procedure is the main hindrance for women to preserve their fertility during cancer treatment despite a number of guidelines available for them. There are a number of techniques available for fertility preservation that can be used to maximize efficiency. Cryopreservation method is the most popular one to store Oocyte and embryo. Ovarian tissue cryopreservation is also an effective fertility preservation technique to be weighed against morbidity and mortality associated with cancer.
Chief Female Fertility Preservation Options for Cancer Patients
- Embryo cryopreservation
- Ovarian tissue cryopreservation (ovarian tissue freezing)
- Oocyte cryopreservation (egg freezing)
- Ovarian suppression
- Laparoscopic oophoropexy (ovarian transposition)
- Radical trachelectomy (cervical cancer)
- Ovarian tissue transplantation, orthotopic
- Ovarian tissue transplantation, heterotopic
- Uterine transplantation
A number of patients developed cancer in their reproductive years. They have to go through chemotherapy, radiation, and surgery in order to who survive cancer. During this journey, a lot of the women experience damages in their fertility and find ways to recover it. Chemotherapy and radiotherapy are the primary mainstays of cancer treatments. Chemotherapeutic drugs have a lot of impact on the ovary is variable ranging from no effect to complete ovarian atrophy. It also decreases the ovarian reserve. Radiotherapy also affects oocytes and Uterine. Exposure to radiation causes:
- Reduced vascularity
- Damage to myometrium
- Fibrosis and hormone-dependent endometrial insufficiency
- Adverse reproductive outcomes
Fertility Preservation Techniques in Females
Embryo cryopreservation: Embryo cryopreservation requires the patient to go through IVF. The sperm sample is collected for oocyte fertilization from her partner. Embryo cryopreservation offers a good success rate depending on the number and quality of embryos stored. There is encouraging data on pregnancy and live birth rates in cancer patients after the frozen embryo transfer are limited.
Oocyte cryopreservation: Oocyte cryopreservation is for female patients suffering from cancer and does not have a male partner. This maintains their reproductive autonomy. The patient is taken through ovarian stimulation for this procedure. Success rate with this kind of fertility preservation is high in recent times. More Young women suffering from cancer before marriage choose this process to store fertility.
Ovarian tissue cryopreservation (OTC): Ovarian tissue cryopreservation is a popular fertility preservation procedure in Cancer patients that involves obtaining ovarian cortical tissue that is rich in primordial follicles, prior to ovarian failure by laparoscopy or laparotomy. This is one of the most successful procedures that have given a chance of being pregnant and delivering the baby to a cancer survivor.
In vitro maturation (IVM): IVM involves aspiration of immature oocytes after minimal or no stimulation followed by cryopreservation of mature oocytes or embryos generated after fertilization. In the first step of this procedure, immature oocytes are collected in the luteal phase and from antral follicles in the ovarian tissue removed for cryopreservation. This technique can be applied to very young girls as well.
Why is it important to stop fertility for female cancer patients?
Cancer takes away a lot of physical stamina and spirit of the patient even after the successful completion of the cancer treatment. It has multiple scars and marks left on the patient body after the treatment. As a matter of fact, the patient is left with a low dignity and sometimes a less spirited life. Having their fertility preserved give them a chance to live again. They can start to build up their family and proceed towards a better life. Having a child in their life will give them the required push to accept their life and live with a goal.