Fertility Preservation for Cancer Patients

Overview

Women of reproductive age that receive a diagnosis of cancer may be facing potential loss of future fertility or diminishment in the chances of future childbearing. Some surgeries and many forms of chemotherapy or radiation therapy to the pelvis may severely compromise ovarian or uterine function. In the past, there were limited options presented to cancer patients in regards to fertility preservation. Today, in addition to the possibility of freezing of embryos, women now have the option of freezing their unfertilized eggs so that these may be fertilized and implanted at a later date. This significant step forward in fertility treatment enables women that are not yet partnered to preserve hope of having a child with a future partner. 

Embryo freezing, as well as third party parenting options such as egg donation, surrogate pregnancy or adoption still are viable and attractive options for many slightly older cancer patients. For younger women who know that they may want to extend their fertility potential, egg or oocyte freezing (also called fertility preservation) provides the ability to preserve a woman’s own genetic material until such time as she medically cleared and ready to start her family.

Fast-Tracking Treatment. 

We recognize that a new diagnosis of cancer is a frightening experience and patients are grappling with all the important medical treatment decisions. Plus, most oncologists (cancer physicians) and the patients themselves are anxious to get on with treating the malignancy as soon as possible. Therefore, we have a special treatment protocol whenever we have a patient or oncologist call us about fertility preservation. We will arrange for an immediate appointment with one of our doctors. We will “fast track” the patient through the IVF preparation process and we can even start medications at any time in the menstrual cycle, avoiding any delays to obtaining eggs as soon as possible.

Pacific Fertility Center has been freezing eggs since 2007 when we first embarked on a project freezing donor eggs. Since then, we have performed many cases of egg freezing with success. While once considered an experimental procedure, success with egg freezing has lead to widespread acceptance.

As with egg and embryo freezing for infertility or routine fertility preservation, there is no way to guarantee or know what the outcomes will be at the time of thawing the eggs or embryos. We suggest a detailed discussion with your PFC physician before choosing this option.

Preparing for Egg Preservation

The egg freezing process begins with In Vitro Fertilization (IVF) so that multiple eggs may be produced for freezing.  A substantial number of eggs provide ample opportunities for fertilization later on. 

The Egg Freezing Process

This process involves steps similar to In Vitro Fertilization (IVF), beginning with a series of fertility enhancing medications to produce multiple eggs and then retrieving the eggs. You can learn more about the egg freezing process on our new website dedicated to providing information on fertility preservation.

Fertility medications. The first step in this process is to generate multiple eggs for retrieval. Your physician will prescribe fertility medications to stimulate follicle growth and produce multiple eggs. Medications are injected subcutaneously (just beneath the skin) with a very fine needle. As always, our staff will counsel and instruct you on this process and be available to you throughout. This phase of treatment lasts approximately 10 days.  

Ultrasound monitoring and lab tests. Your physician will monitor you on a regular basis to assess follicle growth and the number of eggs you are producing. When eggs are determined to be mature and ready for retrieval, you will stop taking the fertility medication and receive one injection of hCG, a hormone that prepares eggs for ovulation so they may be retrieved.

Egg retrieval procedure. This is a painless and relatively brief procedure, during which your doctor will use ultrasound guidance to gently retrieve eggs from the ovarian follicles. You will be under sedation throughout the procedure. The retrieval is performed in our clinic; patients are able to resume normal activity shortly after the sedation has worn off.

Learn more about IVF and Egg Retrieval.

Egg preservation.  Your eggs are preserved through a rapid freezing process called vitrification. Eggs remain frozen until they are needed. The eggs may be kept frozen indefinitely so it is critically important that patients maintain annual contact with the clinic so we know the eggs have not been abandoned. Learn more about vitrification. 

Using Frozen Eggs to Create Embryos

Thawing. When you decide that you are ready to use your eggs, they will be thawed in the laboratory. The thawing is a rapid procedure performed on the day the eggs will be fertilized and must be synchronized with a woman’s cycle. Over 90% of frozen eggs should survive the freeze-thaw process.

Fertilization. Thawed eggs are next fertilized in our laboratory using a procedure called ICSI Intra-Cytoplasmic Sperm Injection in which a single sperm is injected into each egg. Because the protein coat surrounding a frozen-thawed egg is hardened by the freezing process, ICSI rather than conventional mixing of eggs and sperm is required for successful fertilization. Learn more about ICSI. 

Embryo transfer. Prior to transfer, your doctor will discuss with you the number of embryos recommended for transfer.  This number is based on a number of factors. Your doctor will transfer the fertilized eggs (embryos) into the uterus using an abdominal ultrasound.  The transfer feels similar to a Pap smear and does not require anesthesia. The procedure takes about 15 minutes (the transfer itself takes just 30 seconds). Learn more about the transfer procedure. 

Re-freezing of excess embryos. According to the decision you make with your physician, excess embryos may be re-frozen. Re-freezing the fertilized eggs is safe and will make it possible to do another transfer if the first one does not work or possibly even have a future child if the first transfer does work.   

Financial Concerns

We know that most insurance companies will not cover the expenses involved with egg and embryo cryopreservation, even for cancer patients. So unless that patient happens to have IVF infertility coverage under their current group plan, the expenses will be out-of-pocket. We have special discount pricing off of our IVF prices for cancer patients and there are ways to pay for egg freezing that you can use. We also work with Fertile Hope, a cancer fertility advocacy and support group to provide medication discounts. In addition, there are resources through some of the pharmaceutical manufacturers (Merck) to obtain free medications for IVF.