Fertility preservation: an overview of the different types and why people opt to do it
Written by:Fertility preservation, the term often used to describe various procedural options that provide a patient with the opportunity to delay having children until a later time, is incredibly useful for those who are faced with the risk of potentially losing their fertility.
In our latest article, London-based expert fertility specialist, Dr Irfana Koita, outlines and analyses the numerous reasons why some opt to preserve their fertility.
Why do people decide to preserve their fertility?
Nowadays, men, women and couples may want to preserve their fertility for a variety of reasons, which typically fall under two main categories: social reasons and medical reasons.
Years ago, only patients who were on the verge of undergoing treatments for certain diseases and conditions were offered the opportunity to freeze their eggs or sperm. Nowadays, however, the wider populous can decide whether the option is suitable for them or not.
Of course, we are not all predisposed to start a family at the same time. Some of us may wish to delay starting a family due to a variety of different reasons. The main social reasons for not starting a family generally include:
- not having met the right person yet
- not feeling financially stable or not emotionally ready
- opting to pursue a career
In such cases, advancements in fertility science and vitrification procedures; not previously available to non-medical patients; now offer a scientifically viable option to preserve one’s eggs, sperm, embryos and even reproductive tissues to secure a biological family in the future.
When individuals are on the cusp of undergoing various types of cancer treatment, they may wish to consider the option of preserving their fertility. This may be the best option, as some of the medications used can cause infertility, especially in high doses.
Generally, the most common reasons individuals may be offered fertility preservation for medical reasons are:
- they are about to undergo chemotherapy
- they are about to undergo radiation therapy
- they are commencing hormone therapy
- they are about to undergo reconstructive surgery
- they have a genetic condition which may decrease their fertility
Important to highlight here, is the fact that fertility preservation can be completed in a relatively short amount of time, thus allowing the patients to continue undertaking treatment for cancer or other conditions within a reasonable timeframe.
Types of preservation
Women either undergoing treatment that might affect their fertility (for example, a cancer pathway) can choose to freeze their oocytes (eggs), but if they find themselves in a sound relationship, they then may wish to decide to freeze their embryos instead as embryos are more likely to survive the thaw process than eggs. Once thawed, success rates are comparable with fresh embryos during an IVF treatment.
Overall, the process is relatively straightforward. Women will undergo the first part of an IVF cycle, which entails taking medications to stimulate the ovaries to produce eggs. The woman is then sedated whilst her eggs are collected.
The eggs are then fertilised with her partner's sperm using IVF or ICSI, depending on the quality of the sperm. The fertilised eggs are then observed and analysed for viability and are thereafter frozen in special tanks of liquid nitrogen in a process called vitrification.
They are typically stored for 10 years, but this period can be extended in special circumstances for up to 55 years. The quality of the embryos is not affected by the length of time that they are frozen.
Another type of preservation available is the egg freezing process. Within this process, the woman will undergo the first half of an IVF cycle, including taking medications to stimulate her ovaries. Her eggs are collected under sedation and immediately frozen and stored in a tank of liquid nitrogen.
In the event whereby a woman wishes to use the eggs, they then go through a thawing process, and those that survive are injected with sperm. A fertilised embryo is then transferred to the woman’s womb.
It may be necessary to take special medications prior to an embryo transfer in order to fully nourish the womb lining, as doing so can develop a natural endometrium before a transfer. Depending on the patient’s age and ovarian reserve, they may be recommended to have more than one cycle of treatment to ensure that they have sufficient high-quality eggs in preservation.
Sperm freezing is another one of the main preservation options available for patients. People may wish to consider sperm freezing if:
- they have a condition, or are facing medical treatment for a condition that might affect their fertility
- they are considering undergoing a vasectomy and want sperm available in the case of a change of mind regarding having more children in the future
- they have a low sperm count or the quality of their sperm is deteriorating
- they have difficulty producing a sperm sample on the day of fertility treatment
- they are at risk of injury or death i.e., they serve in the Armed Forces
- They are a male transitioning to a female and they may want to preserve their fertility before they begin hormone therapy or have reconstructive surgery, both of which can lead to the partial or total loss of fertility.
Something worth highlighting here is that using frozen sperm during IVF is just as successful as using fresh sperm. However, not all sperm survive the thawing process. The standard period for storage of sperm is 10 years, but this can be extended to 55 years in special circumstances.
Using a patient’s sperm in treatment will require it being thawed as part of an IVF procedure where the pathway may include intraterine insemination, IVF itself, or ICSI (Intracytoplasmic Sperm Injection).
If you are considering preserving your fertility, you can book a consultation with the highly esteemed fertility expert, Dr Irfana Koita, by visiting her Top Doctors profile today.
