Egg and Embryo Banking - Basics

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When a girl or woman is diagnosed with cancer, the patient and physician will discuss treatment options.

Cancer treatments such as radiation or chemotherapy can damage the ovaries and pose a threat to fertility. If there is enough time before treatment begins, and a woman is old enough, the most mature option for fertility preservation is embryo banking.

Embryos can be banked after hormonal injections that are part of a procedure commonly known as in vitro fertilization or IVF.  IVF is a well-established procedure that has resulted in thousands of successful pregnancies in women who have had difficulty conceiving naturally. For cancer patients, the hormone injections must be performed quickly in the few weeks before starting cancer treatment.

How does embryo banking work?  The first step is the use of hormone injections to stimulate a large number of follicles to produce mature eggs. Hormone injections may not be suitable for women with certain types of cancer; ask your doctor if this is an option for you. The procedure is monitored closely with blood draws and a series of ultrasounds. It takes about two weeks to produce enough mature eggs for the next step: egg retrieval.

To retrieve eggs, the patient receives a medication that induces ovulation within 36 hours. Using ultrasound to help guide a needle inserted through the vagina, the doctor will retrieve the mature eggs. This procedure is quick, minimally invasive and can usually be done in a doctor's office. Once egg retrieval is completed, a woman can begin her cancer treatment.

After the eggs are retrieved they are placed in a dish and sperm are added to fertilize the eggs. Alternatively, a single sperm can be injected into each egg using a technique called intracytoplasmic sperm injection, or ICSI.

After fertilization, the egg develops over the next 2-3 days to form an embryo. Finally, the embryos are frozen and stored so that they may be used to achieve a pregnancy at a later date after a woman's cancer treatment is completed.

But what about a woman who does not have a partner or access to a sperm donor, or who does not want to create or freeze embryos?  In this case, the eggs that are retrieved from her are frozen and stored in a process called egg banking. The eggs would then be thawed and fertilized at a later date to create embryos. The pregnancy success rate is lower using frozen eggs than with frozen embryos, however.

Because each fertility preservation option has its own risks and expected success rates, it is important to talk with your doctor to determine the best fertility preservation strategy for you.