Fertility Preservation

Indications

Cancer

If you have a recent cancer diagnosis, we will see you within 24-48 hours of that diagnosis. Please phone the Family Fertility Center at (610) 868-8600 to make an appointment with our physician as soon as possible.

At the Family Fertility Center, we understand the devastation you experience with a diagnosis of cancer. Treatment for cancer must be undertaken expeditiously to optimize survival. Yet many cancer treatment including chemotherapy and radiation can have irreversible damage on reproductive organs. We are here to provide you with you with the information you need so that you are fully informed of your fertility preservation options prior to cancer treatment.

Other indications for fertility preservation

• Treatment with chemotherapeutic agents for non-cancerous disease such as autoimmune disease, collagen vascular disorder
• Genetic predisposition to accelerated ovarian aging
• Environmental or occupational exposure of hazardous materials to reproductive system
• Reproductive disease such as severe endometriosis or pelvic adhesions
• Prevention of age related decline in fertility

Fertility Preservation Options

For the Male

Semen freezing and banking has been successfully carried out since the 1950’s when glycerol was accidentally discovered to protect the sperm from the damaging effect of freezing. The semen quality from a man newly diagnosed with cancer is generally poorer in quality than before. But there is typically enough sperm in a semen sample to fertilize the eggs recovered in an IVF cycle using intracytoplasmic sperm injection. Up to a third of man may develop a persistent total lack of sperm in the semen after completion of radiation or chemo-therapy. If such a condition arises, most experts agree that the frozen sperm should be used in conjunction with an IVF cycle rather than an intra-uterine insemination procedure.

Fertility Preservation Options

For the Female

Emergency IVF and embryo freezing
This is still the gold standard endorsed by the American Society for Reproductive Medicine. However it does require that you have a male partner or be willing to accept donor sperm in order to fertilize your eggs. IVF treatment must be undertaken expeditiously so as not to delay your cancer treatment.

Because of the concern of excessive estrogen exposure to cancer known to be hormone sensitive, such as breast cancer, non-traditional medications such as aromatase inhibitors may be used instead of standard IVF medications. In the alternative, in-vitro maturation of oocytes may be performed followed by intracytoplasmic injection and freezing of the embryos.

GnRH analog
Medical treatment with GnRH analogs, e.g. leuprolide acetate, has been advocated by several small studies as an option to preserve female fertility against damages by chemotherapeutic agents. The effectiveness of this treatment has not been substantiated by objective evaluation. Ongoing multi-center study in the U.S. is examining whether leuprolide, a GnRH analog, is effective in protecting the ovaries from the toxicities of chemotherapy.

Ovarian tissue cryo-banking before cancer treatment
Over a dozen babies have been born after ovarian tissue was harvested from one ovary before cancer treatment and kept frozen until the patient recovered from cancer treatment. The frozen ovarian tissues were re-implanted on the pelvic wall or onto the remaining ovary. Successful pregnancies resulting from spontaneous ovulation after re-implantation have been documented although experts agree the re-implanted ovarian tissue generally have a short life-span.

Egg Freezing
Click here for more information about Egg Freezing

References

• Preserving Fertility in Women