What is involved in each of the available options for fertility preservation?
Embryo freezing: Embryo freezing is the best studied and most widely used form of fertility preservation. Embryos are obtained through an advanced fertility treatment called in vitro fertilization (IVF). IVF has resulted in millions of live births in women and men with infertility. The ovaries are stimulated with injections of hormones which stimulate follicles on the ovaries to produce mature eggs. The process is closely monitored during 1-2 weeks of ultrasounds and blood draws. Once the eggs are mature, the egg retrieval procedure is performed using an ultrasound-guided needle while you are asleep under anesthesia. The process takes about 20 minutes. Eggs are fertilized with sperm and fertilized embryos are frozen for later use. Cancer treatments can begin shortly after the egg retrieval.
Egg freezing: The process is the same as for embryo freezing, however eggs are frozen and are not fertilized with sperm. These eggs can then be thawed and fertilized in the future if and when they are needed. Egg freezing is a newer technology, but it is no longer considered experimental and may be an ideal option for young women, women without a partner, or patients who have personal concerns about embryo freezing.
Ovarian tissue freezing: This technology is offered at Cleveland Clinic under an experimental protocol. Ovarian tissue freezing is an option for women who can not wait 2-6 weeks to begin their cancer treatments or for women who cannot undergo hormonal stimulation. Ovarian tissue is surgically removed through a minimally invasive procedure and frozen until chemotherapy and/or radiation therapy is completed. The thawed tissue can then be re-implanted into the pelvis. It may then regain function well enough to release an egg and allow for “natural” pregnancy. Eggs from the transplanted tissue may also be removed for in vitro fertilization.