Fertility preservation is a process recommended to patients diagnosed with cancer and who want to preserve their fertility while undergoing treatment for cancer. Chemotherapy and radiation may affect the ovaries or testicles especially when radiation therapy is carried out in the pelvic area. Chemotherapy drugs have levels of risk attached with it. The treatment involves attacking rapidly multiplying cells in the body. Hence the drugs don’t just attack the cancerous cells, they also attack other healthy cells including the sperm in a male human body and ovarian follicles which is the egg produced in the female human body. Some cases where surgeries are required, there are chances that the reproductive functions of a human body may be affected hence affecting fertility.
Patients undergoing cancer treatment may be diagnosed with a temporary loss of reproductive function which can also be termed as temporary infertility and some may be diagnosed with a permanent loss of reproductive function. High levels of radiation, chemotherapy and/ or surgeries may be result in symptoms that are similar to menopause in women and andropause in men. This could also lead to weak bones, mood swings etcetera in women due to lowered estrogen levels and testicular insufficiencies in men.
Some of the methods of methods of fertility preservation are elaborated below.
1. Semen Cryopreservation – Semen cryopreservation is a technique used to freeze the sperms. Men wanting to preserve their fertility before beginning cancer treatment can use this option. Here, the sperm is obtained through masturbation for men. In the case of pre-pubescent boys, techniques like testicular aspiration or electro stimulation can be used to obtain the sperm and stored or frozen for the future.
2. Oocyte Cryopreservation – Oocyte cryopreservation is a technique used to extract, freeze and store a woman’s eggs which are also called oocytes. This process is chosen by female patients who are diagnosed with cancer and want to preserve their eggs before beginning the treatment. This is mainly because the treatment routine would lead to infertility in female humans. This option is also used by the women who are undergoing treatment using artificial reproductive technology (ART) such as In Vitro Fertilization. Some women also choose this method of preserving their eggs if they are delaying plans to get pregnant due to various reasons. The process of retrieving eggs for oocyte cryopreservation is just the same that for in vitro fertilization. Women are given drugs or injected hormones to stimulate the release of eggs. Post maturity of the eggs, they are retrieved via transvaginal oocyte retrieval from the female human body. These eggs are dehydrated before freezing using cryoprotectants. Cryoprotectants replace the water in the eggs and stall the formation of ice crystals that destroy the egg cells. These eggs are then frozen using techniques like slow cooling at controlled rate or vitrification. Vitrification is a faster way of freezing eggs and it freezes the eggs to a glass like solid cell and with ice crystals. During freezing, the egg shell is modified by an embryologist to prevent fertilization. When an egg is to be used, it is thawed and a sperm is injected into the egg with a needle to facilitate further fertilization.
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