Fertility can be affected by age, medical conditions, and treatments. If your future fertility may be at risk, there are steps you can take to press the pause button. Fertility preservation is the process of saving healthy eggs, sperm, or embryos so that they can be used at a future date.
Reasons to Consider Fertility Preservation
Sometimes having a baby right now just isn’t an option but future changes may make a pregnancy difficult later on. Fertility preservation may be considered if:
- There is a medical condition that may affect future fertility, such as a genetic disease, uterine fibroids, or endometriosis
- Medical treatment is needed that may impact fertility, such as chemotherapy or radiation therapy
- Want to delay having children for personal reasons
Protecting Reproductive Organs
Certain steps may be available to protect a person’s reproductive organs prior to harmful treatments, such as radiation therapy. Both men and women can preserve their fertility through gonadal shielding. This method protects the testicles or ovaries from radiation with a lead shield during any exposure to treatments that may harm fertility.
Another procedure, called ovarian transposition, is available to women. It is a minor surgery that moves the ovaries away from an area that will receive treatment. The fallopian tubes may also be moved during the procedure.
Male Fertility Preservation
If protection isn’t possible, men can preserve their fertility through a process called sperm cryopreservation, also known as sperm banking. The man provides a sperm sample which is frozen and stored for future use. This method could be used for males as young as their teens as long as they’ve reached puberty.
Female Fertility Preservation
Women have the option to freeze and store unfertilized egg samples using a process called oocyte cryopreservation. This method can also be used for teen girls who have reached puberty.
Embryo Cryopreservation
In addition to storing frozen eggs, embryos can also be frozen and stored for future use using a process called embryo cryopreservation. In this process, eggs are removed from a woman’s ovaries and fertilized with sperm from a partner or a donor. The embryo is then implanted in a women. The fertilization process is known as in vitro fertilization.
Success Factors
Fertility preservation is most effective when healthy eggs or sperm are frozen. It should be done at as early an age as possible and before having treatments that harm fertility. Damage to sperm and eggs is higher later in a person’s reproductive years and after treatment has been started. Keep in mind that eggs don’t survive cryopreservation as well as embryos. This is because they are a single cell a more likely to become damaged during the process.
The success of implanting a previously frozen embryo depends on many factors, such as maternal age, overall health, and the number of embryos transferred.
There are many fertility preservation options available. Talk to your healthcare team before undergoing major treatments if fertility is a concern. The treatment plan may be able to be adjusted to preserve fertility. If treatment cannot be altered or you wish to delay pregnancy to a later age, talk to your doctor about whether any of these options are right for you or your partner.
RESOURCES
American Congress of Obstetricians and Gynecologists http://www.acog.org
Centers for Disease Control and Prevention https://www.cdc.gov
CANADIAN RESOURCES
Health Canada https://www.canada.ca
The Society of Obstetricians and Gynaecologists of Canada http://www.www.sogc.org
References
About fertility preservation. Alliance for Fertility Preservation website. Available at: http://www.allianceforfertilitypreservation.org/. Accessed October 18, 2018.
Fertility preservation. Cancer.Net website. Available at: http://www.cancer.net/research-and-advocacy/asco-care-and-treatment-recommendations-patients/fertility-preservation. Published May 28, 2013. Accessed October 18, 2018.
Fertility preservation: Options for women who are starting cancer treatment. Memorial Sloan Kettering Cancer Center website. Available at: https://www.mskcc.org/cancer-care/patient-education/fertility-preservation-women-starting-treatment. Updated June 14, 2017. Accessed October 18, 2018.
What is fertility preservation? National Institute of Child Health and Human Development website. Available at: https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/Pages/fertilitypreservation.aspx#available. Accessed October 18, 2018.
Revision Information
- Reviewer: EBSCO Medical Review BoardMichael Woods, MD, FAAP
- Review Date: 01/2018
- Update Date: 03/14/2019