If you are reading this blog, then you or a loved one may have been recently diagnosed with a serious medical condition and are facing impending treatments that could cause infertility. Powerful drugs, radiation therapy, or possibly surgery could soon destroy your egg supply or ability to carry a baby. If this is the case, first, let me say that I am sorry that you must go through this, but there is real hope that a fertility specialist can preserve your ability to have a child. Time is likely short, and you may need to make a quick decision to guarantee fertility preservation.
First you must have a conversation with the doctor who is treating you. Find out exactly what the treatment plans is and ask what the expected impact on your fertility is. Obviously, your overall health and overcoming the disease is most important, but perhaps there are less harmful options that are just as successful. Ask if any delay in starting treatment is acceptable. Although this is a discussion you need to have with the treating doctor, don’t be shy about searching the internet or getting a second opinion. A good physician will not be offended if you ask the questions when so much is at stake.
If you are faced with highly toxic medications, then get the list of drugs from the doctor. Not all cancer meds injure your egg reserve. Understand the risk to your fertility. If in fact you are to receive a drug that is likely to permanently injure your ovaries, receive damaging radiation therapy or major surgery then know that there are likely several options.
If you can delay treatment for a couple of weeks then you can have eggs harvested after a quick treatment cycle with fertility medications. The eggs can be either frozen in an unfertilized state (known as an M2, or Metaphase 2 oocyte) or, if you’re married or have chosen the father of your children, embryos can be made and frozen. Even if you are in the second half of your menstrual cycle we can always proceed with the stimulation procedure and egg retrieval. If you are familiar at all with IVF cycles then you are probably thinking that the process requires weeks of preparation. Actually that is not true if all we only need is your eggs and don’t care about your uterine lining because we are not putting the embryos back in you at this time. It will not affect success. The average length of the whole process is 10-12 days and usually after 2- 3 days the Oncologists can begin their treatments.
If your doctor cannot allow you to wait the 2 weeks require to freeze mature eggs, then ovarian tissue cryopreservation is a possible option. A surgical procedure known as laparoscopy is performed and one of your ovaries is removed. It is a brief, 20-30 minute surgery that should only delay chemotherapy start by 6-7 days or less. In the fertility laboratory the ovary is cleaned and prepared for freezing as little strips. Just how these frozen strips are used to regain your fertility can vary depending on the circumstances. For example, if there is no risk that your ovary harbors cancer cells then, when your cancer doctor clears you, thawed ovarian strips can be replaced in your pelvis near your tube. This has been successfully accomplished. If, however, there is a suspicion of residual cancer then there is concern about replacing this tissue into the body maturation and reseeding the cancer. If such a risk exist, there is still hope. Alternatives exist that are experimental but have great hope of success in the near future. In the meanwhile your ovary is frozen and safely stored in the lab.
If radiation to the pelvis is planned then ask if there is benefit in having your ovaries surgically lifted out of the pelvis. This is a quick and easy surgical procedure but it seems that nowadays it is rarely needed.
Most often we can go with the first option which is egg freezing. I know it may sound expensive and out of reach for you but at Fertility Partnership we will do everything we can to make it possible. You just have to make the call.