Fertility preservation for oncology patients
Hunter IVF works closely with the Newcastle Private Hospital’s oncology department to help preserve the fertility of women and men who will need treatment for cancer.
After cancer treatment, infertility may be caused by:
- The ovaries being unable to produce mature eggs,
- Disruption in hormonal signalling between the brain and the ovaries,
- Damage to the uterus or fallopian tube from surgery to the abdomen or pelvis, or radiotherapy,
- Chemotherapy causing temporary or permanent damage to eggs and follicles.
You may choose to preserve your fertility before cancer treatment, so that you have the chance to have a family once you are well. Mature eggs (medical egg freezing), embryos and ovarian tissue can all be frozen and preserved, and there are also some medications that can protect your ovaries from damage during chemotherapy. The type of cancer you have, your treatment plan, your age and circumstances will all need to be considered.
While embryo and sperm freezing are well-recognised infertility treatments, with many thousands of babies born as result, egg freezing is a relatively new option for fertility preservation.
Recent work by Australian and international scientists has resulted in improved techniques for egg freezing and thawing, and there have now been over 900 babies born worldwide after this procedure.
Frozen eggs may be stored for many years. When the woman is ready to use her eggs, they are thawed, and then fertilised with sperm. A healthy fertilised egg will develop into an embryo, which may then be transferred to the woman’s uterus, with a subsequent chance of pregnancy.
Fertility decline with age
If you want to have a child in the future, but do not have the opportunity during your most fertile years, you may want to consider freezing your eggs for ‘social reasons’.
During a woman’s reproductive years, the ovary contains hundreds of thousands of immature eggs. Usually, one mature egg is released each month, and many hundreds of eggs die off naturally. As a woman gets older, the number of eggs available to go through the maturing process becomes less, until by around the age of 50 no eggs remain, and she goes through the menopause.
A woman’s most fertile years are her 20s and early 30s, when the ovaries still contain a large number of healthy eggs. For the 10-15 years before menopause, despite a woman having regular monthly periods, the ovarian function deteriorates. This is especially so in women in their 40s.
As the technique for egg freezing is relatively new, it is not possible to give precise figures for the chance of pregnancy after freezing.
Currently we would expect that:
• a stimulated cycle would result in the collection of 10-12 eggs
• approximately 60-70% of eggs would survive thawing
• approximately 50-80% of surviving eggs would fertilise
• approximately 90% of fertilised eggs would develop into embryos
• a single embryo would have a 15-35% chance of developing into a pregnancy.
Other factors, especially the woman’s age when her eggs are frozen, have an important effect on the chance of pregnancy: the younger the woman, the better the chance. Egg freezing in women over the age of 37-38 is not recommended as, the likelihood of achieving a pregnancy from eggs frozen beyond this age is extremely low.
Risks of egg freezing
Egg freezing is not a high-risk procedure, but as with any medical or surgical treatments, there are potential complications related to hormonal stimulation and egg collection.
Other risks of egg freezing relate to the possible failure of the treatment. For example, the eggs may not survive the thawing procedure, may not fertilise or develop into embryos, or may not result in pregnancy after embryo transfer.
If you are considering egg freezing, you should have counselling to consider other options that may be available – such as donor insemination (for more immediate rather than delayed treatment) or the possible future use of donor eggs if your own ovarian function is likely to be lost.
You need to be very conscious that freezing your eggs only gives a limited chance of success and certainly does not guarantee that you will be able to have a child using these eggs.
Find out more about our research into fertility preservation
Read more about age and fertility
Contact us for more information about fertility preservation