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Fertility Preservation

Fertility preservation refers to the process by which reproductive tissues such as eggs, sperm can be saved or protected. In this way, such tissues can be used by a person to have biological children at some point.

Who are at benefit from this procedure?

Individuals suffering from certain diseases and disorders that impact on their fertility may benefit from this technique. These include people having:
•    Uterine fibroids
•    Autoimmune disease like lupus
•    Endometriosis
•    Genetic disorder affecting future fertility
•    Cancer: As cancer treatments come with huge ill effects on the fertility of a patient, thus a discussion about this fertility preservation is vital before initiating any cancer treatment
 

When to consider fertility preservation for social reasons?

•    In females: Fertility begins declining from the end of twenties. This process carries on quickly after 35 years because that egg number and egg quality start falling with age. Thus, to attain a good possibility for later pregnancy, freezing of eggs must be done, before starting this natural process.
•    In males, the impact of age on fertility is not as evident as in woman. The risk of fathering a child with genetic irregularities is greater in older males than the young males. In case sperm freezing needs to be done due to social reasons, it is suggested to do this prior to 50 years of age.
 

How can females preserve their fertility prior to cancer treatment?

Females about to go through cancer treatment have a range of alternatives when it comes to fertility preservation. For instance:


Ovarian Tissue Cryopreservation (OTC)
OTC is a process that gives an opportunity to most females (cancer patients) to have children later in life by ejecting and freezing ovarian tissue prior to the initiation of such treatments. In other words, the ovarian tissue can be thawed and re-implanted. This procedure facilitates spontaneous pregnancy as there is a complete restoration of the ovary working. In addition, as the hormone levels return to their standard levels, so the secondary effects associated with early menopause such as heart problems, hot flushes, osteoporosis, can be evaded.


Egg (Oocyte) Freezing
Egg freezing, also referred to as Mature Oocyte Cryopreservation, is a process that saves prospects of a female's pregnancy. In this procedure, the unfertilized egg is frozen, and the fertilization process takes place after the patient’s wish to get pregnant. In a laboratory, the frozen egg is defrosted, mixed with sperm and implanted in the female’s uterus.


In Vitro Maturation (IVM)
In this procedure, the eggs are collected from a female prior to their maturation. In this technique, the eggs go through a maturation process outside the patient’s body in a petridish. It is performed in a laboratory; after the eggs complete their maturation process, they are fertilized and the developing embryo can be transferred in the uterus as it is done in a standard IVF procedure. This procedure is a good alternative when the patient can’t avoid the initiation of cancer treatment and there is negligible time left for carrying out a usual hormonal stimulation for recovering the mature oocytes.
 

How can males preserve their fertility prior to cancer treatment?

Sperm freezing

It is an easy approach by which male fertility can be preserved, with a normally high success rate. The collection of specimens is performed via masturbation. In this procedure, the sperms are preserved by freezing and their storage can be done in liquid nitrogen at a temperature of about 196⁰C and can be used afterwards for fertilizing an egg.


Testicular Epididymal Sperm Extraction (TESE)


In this method, the sperm is retrieved using needle biopsy to get hold of individual sperm from the testes and/ or the epididymis. The sperm cells are then ejected and frozen for future usage. This procedure is beneficial in males having an obstruction in their vas deferens, experiencing impotence, spinal cord injuries or any other reasons.


Testicular Tissue Freezing


TTF is an outpatient technique in which the testicular tissue is surgically removed and can be frozen for future use. This method is an appropriate option only for pre-pubescent boys or older.
 

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