Fertility Preservation

Fertility Treatment Options

Key Points

People diagnosed with cancer, people who are transgender or who are not ready to grow a family yet, can consider fertility preservation.
There are different methods available to preserve fertility.
It’s important to take time to process information and make a decision that is right for you.

What is Fertility Preservation?

Fertility preservation involves freezing eggs, sperm, embryos or reproductive tissue so that you can have a biological family in the future.

There are several reasons why you might want to consider fertility preservation:

If you are about to receive treatment for cancer

Certain types of cancer treatment may affect fertility. In this case you may want to freeze your eggs, sperm or embryos for the future.

Chemotherapy is a treatment that destroys cancer cells, by interfering with their ability to divide and grow. It also affects other healthy cells in the body and may damage the ovaries, reducing the number and quality of eggs. Some chemotherapy drugs can also affect a man’s fertility. The likelihood of having fertility problems in the future depends on the type of drugs used, the dose given, age and ovarian reserve at the time of treatment.
Radiotherapy is a treatment that is directed at the affected area. For this reason, toxicity is usually limited to the area treated. Pelvic radiotherapy is highly toxic to eggs and often reduces the woman’s ovarian reserve. It can also damage the uterus, by causing fibroids and reduced blood flow. Pelvic radiotherapy is also highly toxic to sperm.

Hormone therapy is used to treat cancers that use hormones to grow, such as some prostate cancers and breast cancers. In women, it may cause periods to become irregular or stop while being taken. Periods will generally start again when no longer taking hormone therapy. In men, hormone therapy may result in less semen, or no semen.
Surgery to remove the prostate also affects fertility as men are no longer able to ejaculate semen. Men may want to preserve sperm before treatment, or it may be possible to collect sperm directly from the testicles in the process of fertility treatment.

If You Are Transgender

A person assigned male at birth transitioning to female or a person assigned female at birth transitioning to male, may want to preserve their fertility before starting hormone therapy or having reconstructive surgery. Both treatments can lead to the partial or total loss of your fertility.

If You Are Not Ready For a Family Yet

For people who aren’t ready to grow their family just yet, either because they haven’t met the right partner, or because they are not financially or emotionally ready, it is possible to preserve eggs/sperm for the future.

Types of Fertility Preservation

1. Egg Freezing
The process of egg freezing involves stimulating the ovaries to produce several eggs at the same time, collect those eggs and freeze (cryopreservation). Vitrification is the most efficient way to freeze eggs. More than 90% of eggs survive the freezing process and fertilization rates are similar to those seen with fresh eggs. These eggs can be used in the future in IVF.

2. Sperm freezing
Sperm freezing is the most effective method of preserving a man's fertility and can be stored from patients as young as 13 if needed. Sperm is usually collected through clean masturbation and frozen.

3. Embryo freezing
Couples in a stable relationship may consider embryo freezing. The process involves the woman undergoing a cycle of ovarian stimulation and egg retrieval as in conventional IVF. The eggs are then fertilized in the lab with the partner’s sperm and frozen.

4. Testicular tissue freezing
Testicular tissue freezing is a specialist technique to preserve the fertility of young boys who have not been through puberty yet. Tissue that contains cells that make sperm is removed from the testicles through a small incision. It is then frozen and stored.

5. Ovarian tissue freezing
Ovarian tissue freezing is a fertility preservation option for women who are unable to freeze their eggs and for younger girls who haven't started ovulating. The process involves a small operation to remove some ovarian tissue, which is then frozen. This is a new treatment in the early stages of development. There is very little evidence at the moment about how well it works but there have been reports of women having babies after this procedure.