Fertility Preservation

Fertility Preservation

Fertility Preservation by Cryopreservation Technique has revolutionised ART treatments and is extremely relevant in the current generation.

Women are born with a fixed number of eggs right from birth and now they have an option of freezing either their eggs / embryos and planning a pregnancy whenever they wish .Cryopreservation is the procedure where sperms, oocytes or embryos are preserved by cooling to a temperature as low as -196 degrees C. At such low temperatures, any biological activity including biochemical reactions of gametes are effectively stopped in time and the gametes can be kept in a frozen state for as long as is needed.

Clinical Situations for fertility preservation

• Cancer patients before starting Chemotherapy / Radiotherapy
• Control of biologic clock – Women can now postpone pregnancy to a suitable time
• Male partners with a travelling job
• Before Vasectomy
• Extra embryos - donor cycle, surrogacy, PCOS

Freezing of Semen Samples

The semen samples both from ejaculate and surgical procedure can be stored for prolonged durations using the semen freezing technique. Cryopreserved Sperm can remain viable for many years and can be used in any assisted reproductive procedures.

Advantages:

This service is of particular importance to men facing the possibility of sterilization due to vasectomy, prostate or testicular surgery, cancer treatments such as radiation or chemotherapy, or occupational exposure to high levels of toxins.

Some men because of work related issues may not be present with their wives during her fertile period.

Therapeutic insemination using their cryopreserved semen allows such couples a chance to follow their desired plan.

It is recommend that a semen sample of the male partner is frozen prior to commencement of assisted reproductive technologies (i.e., In Vitro Fertilization, ICSI) so as to secure a backup semen sample for the prospective procedure, in cases of an inability to collect a fresh specimen on the day of the procedure.

Freezing of Oocyte

Oocyte Cryopreservation, involves stimulating the ovaries with hormonal injections, extracting the eggs through vagina under general anaesthesia, freezing, and storing them in cryocan containing liquid nitrogen. Whenever she wishes, these eggs can be thawed, fertilized with her partner’s sperms and transferred to the uterus so as to achieve a successful pregnancy.

Oocyte Cryopreservation is recommended for:

• To accumulate oocytes in low response patients
• Oncological and non-oncological patients who are going to receive treatment that is toxic to gonads
• Women who wish to postpone motherhood due to career choices, continuing education, not having a partner, or for other personal or medical reasons. Freezing healthy eggs at an early age may optimize chances for future fertility and also avoid the risks of chromosomal abnormalities which might arise at higher age.
• Women who have had repeated ovarian surgery leads to a depletion of the follicular reserve can also opt for egg freezing.

Freezing of Embryo

Embryo Freezing provides couples the option of freezing the excess embryos, which can be used in future cycles. There are many advantages of freezing embryos like Reducing the risk of multiple pregnancies by transferring fewer embryos in the fresh cycle and freezing the extra embryos. The Thaw cycles (use of frozen embryo) do not require ovarian stimulation and ovum pick up; the treatment is therefore significantly cheaper.

Patients at risk of developing Ovarian Hyperstimulation Syndrome (OHSS) can have the option of cryopreserving all embryos & prevent OHSS.

Dr Amrita Tandon has a special interest in fertility preservation and takes a lot of time counselling patients for the same.