Female Cancers, Cryopreservation, and Fertility


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Female-Cancers-Cryopreservation-and-Fertility.pngAre there options for preserving fertility in women who have been newly diagnosed with cancer?

Yes! New technology lets your doctor remove and freeze eggs, fertilized eggs (embryos), or ovarian tissue before treating your cancer. This way, you may be able to have children after your treatment. This process is called cryopreservation or freezing. The kind of cancer you have determines what your options are.

The most common cancers in girls and young women are Hodgkin or non-Hodgkin lymphoma, leukemia, thyroid cancer, breast cancer, melanoma, or gynecologic cancers (cervix, uterus, or ovary). Most of these cancers can be treated with chemotherapy, radiation, or a combination of both. Several factors determine if you are infertile after treatment. These factors include how old you are, the dose and the location of the radiation, and what kind of chemotherapy drugs they give you. Chemotherapy is effective in treating many cancers, but it can cause infertility by harming or decreasing the number of eggs.

Embryo cryopreservation

Embryo cryopreservation is the most common way of preserving your ability to get pregnant in the future. You must undergo a procedure called in vitro fertilization (IVF). In IVF, you will be given hormones to stimulate the ovaries to produce a number of eggs. Once they are developed, the eggs will be removed by gentle suction. Embryos are created in the laboratory by joining together the sperm and the egg. The fertilized eggs or embryos are then frozen. You may even choose to perform genetic testing on the embryos prior to freezing them (called PGD or preimplantation genetic diagnosis). PGD may be used to test for a specific genetic disorder (for instance, to check for the BRCA gene in a woman with breast cancer). If you decide you want to have children after your cancer treatment is complete, one or two embryos can be placed in your uterus (womb) with or without the help of medications.

Not everyone can have this procedure. You’ll have to take medications that make you produce more eggs than usual. In total, the process may take 2 to 3 weeks to complete. Unfortunately, if you need chemotherapy or radiation treatment for your cancer, you may not be able to wait that long. The medications that make your body produce more eggs may also make your body produce more hormones, such as estrogen. Estrogen can make some cancers worse.

Embryo cryopreservation offers the best chance of pregnancy. The odds of an embryo surviving the freezing and thawing process and implanting in your uterus are still higher than the odds of creating a pregnancy from embryos using frozen eggs or frozen ovarian tissue.

If you decide to use embryo cryopreservation, you will need to have a man’s sperm fertilize your egg before it is frozen. If you do not have a partner, donor sperm can be used. If neither of these sperm sources is possible or available to you, then egg freezing is a good option.

Egg (oocyte) cryopreservation

Women may choose this option over embryo cryopreservation if they have no current male partner or for personal/religious reasons. Procedures for freezing eggs have improved greatly over the past 10 years, making this a good option for many women. Despite the success of egg freezing, pregnancy rates are still higher per embryo frozen than per egg frozen. This is because, by the time an embryo is frozen, it has already been fertilized and grown for several days, showing its reproductive potential. This process still involves IVF and usually requires 2 to 3 weeks. You will take medications that will help you grow many eggs. However, after eggs are removed from your body, they are frozen immediately. Unlike embryo cryopreservation, the eggs are not fertilized before they are frozen. After your cancer treatment, eggs that survive the freeze-thaw process will then be fertilized in the laboratory with your partner’s or donor's sperm. Embryos that develop will be placed in your uterus.

It is not clear if more mature (developed) eggs freeze better than less developed (immature) eggs. Also, the gentle suction of immature eggs without using stimulation medications has also been performed, and some pregnancies have been reported. However, this procedure is still considered experimental.

Ovarian tissue cryopreservation

Doctors have been experimenting with a procedure to freeze the tissue that contains resting eggs from a woman’s ovary. In this procedure, doctors cut the tissue from one of your ovaries into thin slices. These slices are then frozen.

After your cancer treatment, the doctors can place a slice of thawed ovarian tissue back into your body. You may need to be treated with fertility hormones for this tissue to produce an egg. There are some disadvantages to this procedure. You will have to have surgery several times. It also is dangerous if you have cancer of the ovary. If the tissue has cancer and is placed back in your body, the cancer could spread. It is important for you to know that ovarian tissue cryopreservation is still an experimental procedure. It has not always been successful at all fertility centers, and the success rate is very low.

Fact Sheets/Booklets

View more fact sheets and booklets written by the ASRM Patient Education Committee.
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Assisted Reproductive Technologies (booklet)

This booklet will help you understand in vitro fertilization (IVF) and other assisted reproductive technology (ART) that have become accepted medical treatments for infertility.
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Hormonal Contraception

Hormonal contraceptives contain a progestin (progesterone medicine) with or without an estrogen.
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What do I need to know about Zika virus and trying to have a baby?

Common symptoms include fever, rash, joint pain, conjunctivitis (red eyes), muscle pain, and headache.
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Third-Party Reproduction

The phrase “third-party reproduction” refers to involving someone other than the individual or couple that plans to raise the child (intended parent[s]) in the process of reproduction.

Resources For You

The American Society for Reproductive Medicine (ASRM) is committed to providing patients with the highest quality information about reproductive care.

Cancer

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SART Fertility Experts - Medically Indicated Fertility Preservation

Cancer therapy can affect future fertility and pregnancy outcomes. 
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Fertility Preservation for Cancer Patients

When a person is facing a cancer diagnosis and treatment, having children later in life may seem like a low priority. However, an important part of cancer treatment is to carefully evaluate each person's medical situation, goals for parenthood, and cancer treatment plan. Watch Video
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Male cancer, cryopreservation, and fertility

This can be confusing since the terms are often used interchangeably in the media and casual conversation. View the fact sheet
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Cancer Infographics

ASRM has prepared infographics to illustrate the subject of Canter and Fertility better. View the Infographics

Fertility Preservation

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SART Fertility Experts - Medically Indicated Fertility Preservation

Cancer therapy can affect future fertility and pregnancy outcomes. 
Listen to the Episode
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SART Fertility Experts - Elective Fertility Preservation

Listen to Ellen's story as she shares her journey to parenthood with the help of egg and embryo freezing with Dr. Kelly Lynch, a reproductive endocrinologist.  Listen to the Episode
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SART Fertility Experts - Infertility Advocacy and Government Affairs

In today's episode, Dr. Mark Trolice interviews Sean Tipton about the fact that many infertility patients do not have insurance coverage for treatment. Listen to the Episode
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Fertility Preservation for Cancer Patients

When a person is facing a cancer diagnosis and treatment, having children later in life may seem like a low priority. However, an important part of cancer treatment is to carefully evaluate each person's medical situation, goals for parenthood, and cancer treatment plan. Watch Video

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