Cancer and Future Fertility-How To Preserve !!

                

                                     Author-Dr Richa Sharma(IVF Consultant Mumbai)

Cancer is increasing in prevalence with improved detection and diagnostic techniques so prolonging the life and improving the quality of life.It has been observed to be affecting more of younger age groups so can have a lethal effect of the future fertility by destruction of their gametes (sperm or eggs). As doctor we feel need of spreading awareness at multidisciplinary level regarding preservation of future fertility which needs counseling and guidance at preliminary stages only before the damage happens.

Various Methods-

·         Oocyte/Egg cryopreservation

·         Sperm Cryopreservation

·         Embryo freezing

Method will vary as per the clinical status

Oocyte  cryopreservation.

Egg freezing means removing mature eggs and freezing them for later. This process may also be called egg banking . Its done in cancer patients preferably before exposure to chemo and radiotherapy.Its same like an IVF cycle except that embryos are not formed.Here  medications are given  to stimulate the development of multiple follicles in the ovaries.

Type of cancer can also decide the protocols.

Besides there are now more patient friendly mild stimulation protocol especially in estrogen sensitive cancers

The eggs are retrieved from the patient using a transvaginal technique under anesthesia and are kept frozen for future use by a method called vitrification.  

Frozen eggs can be kept frozen for years(5 years as per ICMR but not specified for cancer cases) till the woman decides to use them for conception  and once the patient is ready to get pregnant, the eggs are thawed and then fertilized using ICSI, an assisted reproductive technology that injects one sperm directly into the egg. The embryos (fertilized eggs) will then be transferred into the woman’s uterus (womb) in order to achieve a pregnancy.

Embryo Freezing 

 It has the highest success rate compared to any other treatment.  Its like normal IVF when eggs are retrieved and mixed with sperms. Once fertilized, the embryos (fertilized eggs) grow in the laboratory for 3-5 days until they are suitable for freezing.  

Sperm Freezing

Sperm Freezing is an effective and simplest way for men who have gone through puberty to store sperm for future use. Many men can store sperm (either from natural ejaculate or from a TESA sample