Fertility Preservation

Preserving fertility potential is a field that has become increasingly important for today’s woman. Currently, there are two main reasons to preserve fertility: medical indications and social reasons.

You may ask yourself: What is fertility preservation, and how is it done?

For Men: Sperm Cryopreservation

It is actually a simple procedure. For men, for example, one or more semen samples are collected and cryopreserved (frozen and stored in a specialized andrology lab) for long-term use. When the man is ready to become a father, the sample is thawed and used to fertilize an egg, completing the fertilization process.

For Women: Egg, Embryo, and Ovarian Tissue Preservation

In women, fertility preservation involves cryopreservation of ovarian tissue, eggs, or embryos through vitrification. In the case of prepubescent patients, the most urgent option is ovarian tissue vitrification prior to treatments such as chemotherapy, especially in cancer patients.

Egg Freezing: An Effective Option

When cryopreserving eggs, ideally mature eggs are retrieved through ovarian stimulation (hormonal control and, in some cases, the use of additional hormones) to collect a sufficient number of mature eggs to be frozen for future fertilization. Oocyte vitrification is also a great option for couples undergoing IVF who do not wish to freeze embryos, or for cases where more eggs are retrieved than will be fertilized, avoiding the need to cryopreserve excess embryos.

Ovarian Tissue Preservation

Ovarian tissue cryopreservation can be performed by freezing strips of ovarian cortex (the most successful method), which involves obtaining tissue strips measuring 1 mm thick, 0.5 cm wide, and 1.5 cm long. Other methods include isolating primordial follicles (immature follicles) or freezing whole ovaries. While many childhood and young adult cancers do not metastasize to ovarian tissue, some cancers with systemic dissemination pose a higher risk, such as leukemia, lymphomas, and neuroblastoma.

Embryo Cryopreservation

Embryo cryopreservation is commonly performed to increase cumulative pregnancy rates within the same cycle, avoiding the need for a new ovarian stimulation. This approach has reduced the incidence of multiple pregnancies and ovarian hyperstimulation syndrome. This option is typically recommended for women with a stable partner.

Medical Reasons to Preserve Fertility

It is remarkable how medicine now offers us the opportunity to postpone parenthood. There are many reasons why couples today choose to delay having children. Additionally, health conditions such as cancer have made fertility preservation a crucial option, as cancer diagnoses are increasingly common among young people. Thanks to medical advances, more young patients now survive cancer treatments and can still fulfill their reproductive goals afterward.

The most common cancers among young men include Hodgkin’s lymphoma and testicular cancer, which generally occurs in the third or fourth decade of life.

In women of reproductive age, approximately 25% of all breast cancer cases occur, and chemotherapy or radiotherapy treatments can negatively impact the production of germ cells.

Other non-cancerous conditions can also make fertility preservation advisable, such as collagen diseases (lupus, nephritis, glomerulonephritis), hematological diseases (sickle cell anemia or those requiring bone marrow transplants), or surgeries involving the removal of one or both ovaries due to conditions like large endometriomas or teratomas, where ovarian preservation is not feasible.