Fertility Preservation

Fertility preservation is the process of saving eggs, embryos, or reproductive tissue for future use. This is done before a medical procedure or treatment that may negatively impact fertility or electively to delay childbearing. The goal of fertility preservation is to give individuals and couples the option to have children in the future.

Elective egg freezing is the process of cryopreserving oocytes (eggs) for future use. Women are born with a population of eggs that steadily declines throughout their life. Women are not able to generate new eggs. This is different from men who continuously produce new sperm. As women get older, the number of eggs in the ovaries declines, and menopause occurs when there are no more eggs remaining in the ovaries. In addition to the decline in egg numbers, egg quality also declines with age. More significant declines in egg number and quality are seen after the age of 35yo. For this reason, individuals may elect to freeze eggs any time before age 40yo, but ideally before the age of 35yo when egg quality is expected to be the best.  The process of egg freezing involves taking injectable gonadotropins daily for 10-12 days to stimulate multiple eggs to develop on the ovaries. Around day 14 of the process, the eggs are extracted vaginally with a simple office procedure. Anesthesia or sedation is given to prevent discomfort during the procedure. The eggs that are retrieved are then processed and cryopreserved the same day. The eggs can remain frozen for many years.

Embryo banking is an alternative to egg freezing for couples who would like to preserve their fertility or those using donor sperm. Retrieved eggs are fertilized with partner or donor sperm to create embryos. Embryos are generally frozen on day 5-6 of development. Preimplantation genetic testing can also be performed on embryos in order to identify the number of genetically normal embryos obtained. Future pregnancy rates from genetically normal thawed embryos are more predictable than pregnancy rates from thawed eggs. This is because not all eggs will survive the thaw process, not all eggs successfully fertilize, and not all embryos are genetically healthy.

Medical Egg or Embryo freezing is an urgent procedure performed on patients who will be undergoing medical treatments that impact the ability to conceive in the future. This includes patients undergoing gonadotoxic chemotherapies, surgical removal of the uterus or ovaries, or pelvic radiation for cancer treatment. These treatments may have a direct effect on the ovaries and cause destruction or depletion of eggs. Patients are typically referred by their oncologist for fertility preservation prior to initiation of their cancer treatment. The process of egg or embryo freezing is started as soon as possible and takes approximately 2 weeks so as not to delay cancer treatment.