Fertility Preservation

What is fertility preservation?

Fertility preservation is the process of saving or protecting eggs or sperm or embryos or reproductive tissue so that a person can use them to have his or her biological child/ children in the future.  It’s an option for adults and children of both genders.

What are the different indications of fertility preservation?

Medically-indicated fertility preservation –

Due to certain medical illnesses or their treatment, fertility gets affected. Here fertility preservation comes as a boon.

  • Cancer:Cancer perse and its treatment- chemotherapy, radiotherapy, and surgery can affect fertility.
  • Autoimmune diseases:Diseases such as Lupus and rheumatoid arthritis and their treatment may cause fertility problems.
  • Reproductive health conditions: Endometriosis and uterine fibroids can make it difficult for the woman to get pregnant as time advances and endometriosis gets worsened and fibroid gets bigger and bigger.
  • Gender transition: A male transitioning to a female, may want to preserve their fertility before starting with hormone therapy or having reconstructive surgery. Either treatment can lead to the partial or total loss of your fertility.

Elective fertility preservation – 

If someone is waiting to have children, they might consider preserving their eggs or sperm or embryos before fertility declines. Some common reasons people choose to delay having children include

  • To first achieve certain career goals
  • To further their education
  • Wanting to meet the right partner.

What are the different types of fertility preservation?

    • Removing and freezing eggs, embryos or sperm for future use. These are done with the help of Assisted Reproductive Techniques.
    • Minimizing the impact of cancer treatment on the reproductive tissues by undergoing a few procedures like removal or transposition of certain tissue or organ.

Oocyte/ egg preservation

  • Freezing eggs or egg banking, also called oocyte cryopreservation, is a relatively new method of fertility preservation where a mature, unfertilized egg is retrieved from a woman, frozen, and stored for future use.
  • After controlled ovarian stimulation, the eggs are collected and then frozen with a flash-freezing method known as vitrification. They are then stored until needed for extended periods of time till the female is ready for pregnancy.
  • Nowadays freezing eggs usually have a good success rate. Around 90 percent of eggs survive the thawing process. Of those, about 75 percent are successfully fertilized. This number is variable based on the health of the egg, the health of the patient or gestational carrier, and other factors.

Sperm preservation

  • Sperm freezing is collecting, analysing, freezing and storing a man’s sperm. The samples are later used for fertility treatments or donated to other couples or individuals, including same-sex female partners. This overall process is known as cryopreservation and is also referred to as sperm banking.
  • The patient masturbates and ejaculates semen into a sterile container. This is then used for freezing and storage.
  • If a patient is unable to produce a specimen due to illness, anxiety, pain or cultural or religious reasons, a semen sample can be collected by either Electroejaculation, Medication or Vibratory stimulation.

Embryo preservation

  • Embryo preservation is the most common method of preserving fertility.
  • During this process controlled ovarian stimulation is done and eggs are retrieved. They are further fertilized in the laboratory with partner’s or donor sperms and then frozen by vitrification.
  • Vitrification is a newer and a more successful technique that places embryos in a solution of a high concentration of cryoprotectants. Embryos are then immersed in liquid nitrogen, instantly freezing them . By this process, the embryo is stored before ice crystals have a chance to form, thereby increasing the embryo’s chance of survival and viability after thawing.

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