What is a summary of the fertility preservation options for women?

Well, patients who are facing treatment for cancer, which may involve either chemotherapy or radiation therapy or both, potentially have a number of options to explore if they are interested in preserving their childbearing potential.

In the first place, patients always have the option of foregoing any particular strategy for fertility preservation if, for example, it’s not thought that their therapy is likely to have a significant impact on their fertility. Or if they don’t want to carry out one of these options for any other reason.

Active strategies for fertility preservation include, in the first place, something called emergency in vitro fertilization, or emergency IVF for short. This is a strategy which exploits a technology which is currently used primarily to treat infertility patients. It involves harvesting eggs or oocytes from the patient before she starts her therapy, fertilizing them, presumably with her husband’s sperm, and freezing or cryopreserving the embryos for future use. This is a mature technology with a fairly high success rate and it is probably the most commonly used option that we offer at Northwestern.

Some patients don’t have a mate; some patients are single and wish to defer the choice of a mate into the future. Those patients have the option of participating in a research protocol, which involves freezing their eggs before they are fertilized. The reason that this is experimental is because, technically, it is significantly more difficult to freeze unfertilized eggs than fertilized eggs.

A third option, which also involves a research protocol, is the retrieval and freezing of ovarian tissue. This particular option is most appropriate for patients who have a very, very short time frame leading up to their treatment. A timbered which would not permit the medical part of the therapy required for harvesting eggs. Or, patients who, for some other reason, are concerned about the potential effect of the drugs that are used in emergency IVF on their cancer. So these patients may enroll in the study, which involves surgically removing one of their ovaries and freezing or cryopreserving the ovarian tissue for later use. The technology for using that kind of tissue for making babies down the road is still very, very much cutting edge. Babies have been born after frozen tissue has been transplanted back into patients after they’ve had their cancer treatment, but the overall picture for this technology is very much in the future.