Egg Freezing

When is it recommended?

• Those who wish to wait until they’re ready to have a baby: Couples or single women may wish to freeze eggs for use in the future, providing more flexibility around their own fertility decisions.
• Those who are at risk of losing their ovarian function: Women who have been diagnosed with cancer and expect to be treated with chemotherapy or radiotherapy; have an autoimmune disease which requires chemotherapy or bone marrow transplants, or those who may need repeated ovarian surgery, for example, to treat endometriosis.

Techniques for preserving fertility

At IVI, we allow patients to preserve their fertility in ways that are quick, safe and simple. Our clinic offers the following fertility preservation options:

This can be useful for:

• Cancer patients who need to undergo chemotherapy or radiotherapy immediately and do not have time for ovarian stimulation.
• Younger girls who have not yet reached puberty but require cancer treatment. This technique can also be used in conjunction with egg freezing if appropriate.
• Patients for whom ovarian stimulation might be contra-indicated, such as those with hormone-dependent tumours.

Fertility preservation for cancer patients

Loss of ovarian function and fertility are two aspects which cause concern for most female cancer patients. Many find preserving their fertility a source of comfort, hope, and peace of mind while fighting cancer.

Improvements in treatments and screening programmes mean that more and more people are overcoming cancer. The increased survival rate has led to a greater focus on the secondary effects of treatments using chemotherapy and radiotherapy.

At IVI, we have worked hard to find ways to offer cancer survivors fertility preservation options that are safe and straightforward, so that when they feel ready, they can choose to build a family.

The effects of cancer treatment on fertility:

• Premature ovarian failure: A woman’s ovarian cortex contains a set number of follicles, which are gradually lost throughout a woman’s life and cannot regenerate. Radiotherapy and chemotherapy speed up the natural reduction in the number of follicles and prevent them from maturing, and can lead to premature ovarian failure.
• Reduced primordial follicles: The number of follicles which survive following chemotherapy or radiotherapy depends on many different factors such as age, the cancer being treated, the agent used (chemo or radiotherapy), the dosage and the number of cycles.
• Lower egg quality: Not all women lose their reproductive capacity following cancer treatment. However, even those whose ovarian function is restored may find that the quality of their eggs is compromised.
• Risk of complications during pregnancy: Pregnant women who had cancer during childhood experience a higher rate of miscarriage, a greater incidence of intrauterine growth retardation and a greater risk of premature births.
• Bone and cardiovascular problems: Premature ovarian failure can also lead in the longer term to bone and cardiovascular problems as a result of the body’s hormonal functions ending.

There are currently several different options and treatments available to cancer patients to help preserve their fertility:

• Egg freezing using vitrification
• Ovarian tissue freezing, also known as ovarian tissue cryopreservation
• Ovarian transplantation
• Protection of the ovaries (GnRH agonists): This could prevent follicles from reaching their sensitivity threshold to chemotherapy by suppressing granulosa cells. The protective effect of GnRH-a may not be sufficient in the case of more prolonged treatments and higher doses of chemotherapy. Although controversial, the most recent randomised studies indicate some beneficial effects.
• In vitro maturation of oocytes (IVM): This consists of recovering immature oocytes from small antral follicles which have not been stimulated, or have only been minimally stimulated, and cultivating them until they reach maturity. In this way, it is possible to avoid ovarian stimulation and is an alternative to a standard IVF cycle. It may be useful for those for whom ovarian stimulation is contra-indicated, such as patients with hormone-dependent tumours. IVM should be considered as a complementary technique to ovarian stimulation, meaning it should be used where there is no time to carry out ovarian stimulation, or when immature oocytes are obtained following stimulation.

It is important to remember that even by preserving your fertility, there is no way to guarantee a future pregnancy. However, it does make it possible to try.