If you're going to have a medical treatment that results in infertility, or need to put having children on hold, you may be a good candidate for fertility preservation.
For instance, radiation and chemotherapy treatments for cancer can damage reproductive tissue and cause infertility in women. With the option of fertility preservation, you can have the treatment you need and still have a healthy pregnancy later.
Or, you may decide that you want to delay starting a family. Many women choose to postpone motherhood for career reasons, or because they haven’t found the right partner. Fertility preservation allows you to save healthy eggs or embryos until the time is right for parenthood.
UPMC offers several different methods of fertility preservation to help you become pregnant when you want to.
Doctors define fertility preservation as any procedure that helps save a person’s ability to have children.
There are fertility preserving treatments for both men and women. These procedures can save eggs, sperm, reproductive tissues, and embryos so people may have children in the future.
Female fertility preservation means freezing eggs, ovarian tissue, or embryos to use later. Doctors may recommend female fertility preservation if you:
The two basic types of fertility preservation are:
UPMC offers several different ways to preserve women's fertility.
To freeze your eggs, you’ll go through the first steps of in vitro fertilization (IVF). This involves hormone injections and egg retrieval under anesthesia. Specialists will freeze and store the unfertilized eggs to use in the future.
When you’re ready for pregnancy, the frozen eggs are thawed and fertilized in a lab. Doctors then transfer them to your uterus (or the uterus of a gestational surrogate). You may receive progesterone injections for several months to help maintain the pregnancy.
You’re a candidate for egg freezing if you’ve gone through puberty but haven't reached menopause. You don’t need sperm for egg freezing. Women delaying pregnancy for career, personal, or medical reasons can preserve their ability to have a child later.
Doctors recommend storing an average of 20 eggs, with a minimum of eight to 10, to achieve pregnancy. You have a better chance of pregnancy and a live birth if you freeze your eggs at a younger age — in general, younger women have better quality eggs.
Your odds of getting pregnant with stored eggs decreases with age, regardless of how old you were when doctors froze them.
To get pregnant:
Embryo freezing means freezing and storing embryos created through IVF. You receive hormone injections and doctors extract eggs with a needle while you're under anesthesia. The eggs are combined with sperm in a laboratory.
If an embryo (or embryos) result, doctors will freeze and store them for future use. Like frozen eggs, frozen embryos stay in special storage facilities, under strict supervision and monitoring.
When you’re ready to get pregnant, doctors will place the thawed embryos in your uterus. If an embryo implants in the lining of the uterus, pregnancy occurs.
Candidates for embryo freezing are women from post-puberty to pre-menopause. They must be willing to use their partner’s sperm (or donor sperm) to create an embryo.
Embryo freezing has been in use for more than 25 years. Pregnancy rates for frozen embryos range from over 40% for women under 35 to almost 18% for women over 42.
Ovarian tissue freezing is a relatively new treatment that was an experimental procedure until 2020. Generally, women choosing this method of fertility preservation have an upcoming cancer treatment with a high risk of infertility.
Ovarian tissue freezing involves freezing and storing tissue from the outer portion of the ovary (the cortex). This tissue contains the primordial follicles, which each contain a single immature egg.
In ovarian tissue freezing, doctors remove part or all of the ovary. Then they cut the cortex into thin strips and freeze it. Later, doctors thaw the tissue and return it to the body.
Once back in your body, the ovarian tissue starts producing hormones and releasing eggs. You can try to become pregnant naturally or through fertility procedures like IVF.
Because it affects the whole body, chemotherapy for any type of cancer can hurt the ovaries. It reduces the number and quality of your eggs and makes it harder to get pregnant.
Ovarian suppression can potentially minimize the destruction of eggs from chemotherapy treatments for cancer. The procedure involves using drugs called GnRH (leuprolide and goserelin) agonists. These substances keep the ovaries from making the sex hormones estrogen and progesterone.
Ovarian suppression is still an experimental technique for fertility preservation. If you and your doctor choose this method, you'll have injections of GnRH agonist either monthly or every three months. They'll start a few weeks before you begin chemotherapy and continue throughout your cancer treatment.
Ovarian suppression treatment can cause symptoms of menopause. Your doctor may offer you egg or embryo freezing in addition to ovarian suppression treatments.
Ovarian transposition (oophoropexy) is another fertility preservation option for women going through cancer treatment. If you’re receiving radiation treatment in your pelvic area, it may be a good choice. (Ovarian transposition will not protect the ovaries from chemotherapy, which affects the whole body.)
Ovarian transposition is a minimally invasive procedure that happens before radiation therapy begins. Doctors separate one or both ovaries and fallopian tubes from the uterus and attach them to the wall of the abdomen. Doing so lowers the amount of radiation your ovaries receive.
Your ovaries may still receive some radiation. Your doctor will talk to you about having your eggs frozen before the surgery to improve your odds of having children later.
The uterus can’t get moved out of the field of radiation. If your uterus receives a high degree of radiation, it could get damaged, and you may not be able to carry a pregnancy.
Your doctor may use the following drugs in fertility preservation treatments:
Your doctor may also prescribe vitamins, minerals, and antioxidants to help improve your overall reproductive health.
Your fertility preservation appointments will happen in a doctor’s office or fertility clinic. Fertility specialists work together with oncologists and other experts to provide you with the best care.
To freeze eggs or obtain eggs to create embryos with sperm in a lab, you’ll undergo the first steps of IVF.
This includes:
Ovarian stimulation. At the beginning of a planned IVF cycle, you'll come in around the third day of your menstrual cycle for baseline bloodwork and an ultrasound. You’ll receive fertility drugs to boost egg production.
During ovarian stimulation, doctors will check on the progress of developing follicles via ultrasound and bloodwork to see how the eggs are developing. Once mature follicles are present, they’ll administer human chorionic gonadotropin (hCG) to help the eggs mature.
Egg retrieval. About 36 hours after you receive hCG, doctors will retrieve your eggs. They'll place you under conscious sedation (sometimes called “twilight sedation”) through an IV.
Doctors will pass an ultrasound with a small needle into your vagina. The needle pierces the walls of the vagina to remove the fluid and eggs with the follicles in the ovaries. The ultrasound pictures help doctors guide the needle.
Egg retrieval usually takes less than 30 minutes in the doctor’s office. Specialists will freeze and store the unfertilized eggs to use in the future.
Fertilization. If you choose to freeze embryos instead of eggs, a specialist called an embryologist will examine your collected eggs to determine their maturity. They'll combine mature eggs with semen (from your partner or a sperm donor) in a culture dish. This is stored in an environmentally controlled chamber.
About 18 hours later, doctors will examine the eggs to see if fertilization has taken place. When the fertilized egg divides, it becomes an embryo. Specialists will freeze the embryo and store it in a controlled, monitored environment.
You'll be asleep under anesthesia when the doctor makes a small cut in your abdomen. They will insert a narrow tube (laparoscope) to remove tissue from one ovary, or one whole ovary. They'll divide this tissue into thin strips and flash freeze it.
Ovarian tissue may stay stored for several years.
You'll have injections of GnRH agonist either monthly or every three months. It'll start a few weeks before chemotherapy treatments and continue throughout your cancer treatment.
Ovarian transposition is a minimally invasive procedure before radiation therapy begins. Doctors separate one or both ovaries and fallopian tubes from the uterus and attach them to the wall of the abdomen.
Last reviewed by a UPMC medical professional on 2024-09-05.
