Preserving fertility in women with cancer

New Delhi: Many cancer treatments affect the ability to become pregnant, temporarily or permanently.

Fertility preservation (FP) is an effort to retain the fertility of cancer patients, thereby improving their quality of life.

"Due to the tremendous rise in risk of cancer, it becomes essential to opt for preserving fertility. After the cancer treatment, a woman's body might recover naturally and produce mature eggs that can be fertilized. However, the medical team may recommend waiting for six months to two years before trying to get pregnant. The length of time depends on the type of cancer and the treatment used," said Dr. Priti Gupta Fertility & IVF Expert, First Step IVF Clinic, New Delhi.

Fertility Preservation Options:

* Egg freezing

Egg freezing is a well known method of preserving fertility in women. It might be a good choice for women who do not have a partner. For egg freezing, mature eggs are removed and frozen. Once the woman is ready to become pregnant, the eggs can be thawed, fertilized, and implanted in her uterus.

A new method of freezing called vitrification has made egg freezing more efficient and successful. Another alternative could be to freeze half the eggs and fertilize the rest with sperm from a donor and then freeze embryos.

* Embryo freezing

This is the most established and successful method of preserving a woman's fertility. Mature eggs are removed from a woman's ovaries and fertilized in the lab. This is called in-vitro fertilization (IVF).

Thousands of sperm are put in a sterile dish with each egg. Sometimes one sperm is injected into each egg .The embryos are then frozen to be used after cancer treatment. A woman will have a better chance of a successful pregnancy if several embryos are stored.

"For women who are less than 35, a single embryo transfer is the safest way of using IVF to get pregnant so as to avoid multiple pregnancies," said Gupta.

* Ovarian tissue freezing

This process involves removal of all or part of one ovary by laparoscopy. The ovarian tissue is usually cut into small strips, frozen, and stored. Ovarian tissue freezing lets women freeze a vastly larger number of immature eggs for future use. When frozen ovarian tissue is re-implanted into the body and regains its functions, immature frozen eggs within the tissue start developing normally.

Post cancer treatment, the ovarian tissue is placed in the pelvis. Once the transplanted tissue starts to function again, the eggs can be collected and fertilized. The ovarian tissue does take blood supply and she is to produce hormones after its transplanted.

* For women who are not fertile after cancer treatment

Donor egg is an option for women who have a healthy uterus but do not have any eggs. Egg donation is often a successful treatment for women who can no longer produce healthy eggs.

Also, any woman who has a healthy uterus can maintain a pregnancy by the utilizing the donor embryos.