Fertility Preservation

What is Fertility Preservation?

Fertility preservation is the process of saving or protecting eggs, sperm, or reproductive tissue so that a person can use them to have biological children in the future.

Many people decide to undergo this treatment due to cancer and other health conditions, age, delaying a family due to career or studies, and transgender care.

Exploring The Term Cryopreservation 

Cryopreservation is a process that preserves organelles, cells, tissues, or any other biological constructs by cooling the samples to very low temperatures. 

In the case of Fertility Preservation – Cryopreservation means either Embryo Freezing, Egg Freezing, Sperm Freezing and Testicular and Ovarian Tissue Freezing. This process is often used for fertility treatments that create embryos, such as In Vitro Fertilization (IVF), and it assists women to fall pregnant in the future.

The Eggs, Embryo, or Sperm are frozen to sub-zero temperatures and preserved in a very safe environment for later use. This process is available to anyone who would like to preserve their fertility.

Who is eligible for Fertility Preservation or Cryopreservation Treatment?

The preservation of fertility in women, men, and children has become a widely important topic for patients and their families. It is important to note that in most instances, everyone is eligible for fertility preservation.

For Men

Fertility preservation options for men include Sperm Banking, in which a semen sample is produced, frozen, and stored for future use. Another method is Testicular Sperm Extraction, during which sperm is retrieved directly from the testes through a short surgical procedure, and then frozen.

For Women

Fertility preservation options are varied. Embryo Banking, Egg Banking, Ovarian Transposition, and Ovarian Tissue Freezing are all options for women, along with many more solutions, depending on their location, preference, and diagnosis.

For Children

Prepubescent children have fewer options to preserve fertility than adults. However, there are currently a few experimental options available. These include Testicular Sperm Extraction and Ovarian Tissue Banking.

The Full List of Fertility Preservation Options Available:

For those concerned that the options for fertility preservation may be limited, we can confidently say that there are multiple options available and that the process is just a matter of determining the best possible journey for you.

Options include:

  • Shielding
  • Ovarian transposition
  • Gonadotropin Agonist injections
  • Egg banking
  • Embryo banking
  • In Vitro Maturation (IVM)
  • Sperm banking
  • Testicular sperm aspiration or extraction
  • Ovarian Tissue banking

Additionally, if your fertility has already been compromised, there are still multiple options available to you when it comes to starting your family – when the time is right. 

Some of these include:

  • Donor embryos
  • Donor egg cells
  • Donor sperm cells
  • Gestational surrogate

Cryopreservation for Women

Reasons that Women may consider Fertility Preservation:

Women with certain diseases, disorders, and life events that affect fertility may benefit from fertility preservation. 

These include people who:

  • Have been exposed to toxic chemicals in the workplace or during military duty 
  • Have endometriosis
  • Have uterine fibroids
  • Are about to be treated for cancer or undergo radiation treatment
  • Are about to be treated for an autoimmune disease, such as lupus
  • Have a genetic disease that affects future fertility
  • Want to delay having children, or are concerned about age
  • Are planning to undergo transgender treatment

If you are considering the option of Fertility Preservation, book a consultation with one of our Fertility Specialists to determine which course of treatment is right for you.

A Closer Look at Embryo Banking

One of the key options for women pursuing Fertility Preservation is Embryo Banking.

In essence, this is when hormonal stimulation causes the production of multiple eggs, which are removed, fertilized by sperm, and frozen for future use.

The benefits of this process versus Egg Banking are that Embryo Banking is a more established treatment option with excellent success rates, whereas Egg Banking is newer with less data available. The survival of blastocyst embryos is higher than the survival of eggs after freezing. Any normal remaining embryos after IVF may also be frozen for implantation at a later time.

What Does Egg Banking Entail?

Egg Banking, as opposed to Embryo Banking, is a process wherein multiple eggs are removed and frozen for storage and future use.

To break the process down further; daily hormone injections stimulate the ovaries and our fertility specialists monitor the growth of the egg follicles using blood work and ultrasounds. The eggs are then retrieved while the patient is under deep sedation and the eggs are then frozen. 

When a patient elects to use the eggs in the future, they will be thawed and fertilized with sperm from a male partner or a sperm donor. Once fertilized the embryos are cultured in the lab till the day of the embryo transfer.

Ovarian Transposition, Ovarian Shielding, and Ovarian Tissue Banking.

Ovarian Transposition, Ovarian Shielding, and Ovarian Tissue Banking may seem like daunting medical terms, however, they are fairly simple to explain. These are recent additions to the field of Oncofertility and Fertility Preservation.

Ovarian Transposition occurs by surgically moving the ovaries to a different part of the abdominal cavity. One or both ovaries and fallopian tubes are separated from the uterus and attached to the wall of the abdomen, away from where the radiation will be given. This can also be called Oophoropexy.

Ovarian Shielding is another option which means physically shielding the ovaries from the area receiving radiation (most often as a Cancer treatment). A protective cover is placed on the outside of the body, over the area of the ovaries and other parts of the female reproductive system (ovaries, fallopian tubes, uterus, cervix, and vagina).

Further techniques include Ovarian Tissue Banking, where the egg-producing tissue from the ovary is removed, frozen, and stored until the patient has completed their treatment (whatever it may be) and wishes to become pregnant. Ovarian Tissue Freezing for fertility preservation was considered experimental until 2019.

Fertility Preservation for Men

Reasons for Wanting to Preserve Male Fertility

The reasons for preserving female fertility may be clearer. Age is of course a major factor in women. However, there are certain instances in which men may also want to preserve their fertility.

These reasons include:

  • Have been exposed to toxic chemicals in the workplace or during military duty 
  • Are about to be treated for cancer or undergo radiation treatment
  • Are about to be treated for an autoimmune disease, such as lupus
  • Have a genetic disease that affects future fertility
  • Are planning to undergo transgender treatment
  • Are concerned that age may be a factor in sperm motility and sperm count
  • Have testicular injuries 
  • Plan to undergo hormone treatments or taken steroids for sports
  • Plan to undergo a vasectomy

A Closer Look at Sperm Banking

Sperm Banking or Cryopreservation is the simplest way for a man to preserve fertility. This occurs when a semen sample is produced, frozen, and stored for future use. 

The sperm must be banked before any surgery, treatment, chemotherapy or pelvic radiation therapy begins in order to avoid storing damaged sperm. The frozen ejaculate can be thawed later and used for intrauterine insemination or in vitro fertilization.

This is the most widely used option for men.

What is Testicular Sperm Extraction?

Testicular Sperm Extraction is a surgical sperm retrieval procedure used in fertility treatment for men who have no sperm in their ejaculate. 

TESE is used for men with Azoospermia, as well as those with testicular cancer. This procedure is carried out because there is no sperm in their ejaculate due to a blockage in the route between the site of sperm production (the testes) and ejaculation or because there is a partial or complete failure in sperm production in the testes.

In this case, immature sperm cells are retrieved from the testes and can be used to achieve fertilization through ICSI. 

How effective is Sperm Freezing/Banking and How Long can Sperm Be Preserved?

If you have further questions about Sperm Banking or cryopreservation, we’re here to assist.

Sperm freezing has been done successfully since 1953. It’s a highly effective process for people looking to preserve their fertility.

Of course, some sperm don’t survive the freezing process. It is believed that the survival rate of frozen sperm is over 50%.

If the sample is of high quality, this reduction isn’t an issue for successfully conceiving a healthy baby. This is because the average sperm count ranges from 15 million to more than 200 million sperm per milliliter of semen.

Sperm does not lose its effectiveness with a freeze/thaw and it has the same fertilization capacity as fresh sperm.

In terms of the longevity of the freezing process, in theory, sperm could probably be frozen indefinitely — as long as it’s stored correctly inside liquid nitrogen and it was a high-quality sample, to begin with. According to the records, there has been a success with sperm that has been frozen for over 20 years.

Getting the Right Type of Support During Your Journey

Struggling with fertility is challenging. Despite the many treatment options available to you, and the very workable solutions offered through Fertility Preservation, it is still a difficult journey.

Make sure that you are surrounded by friends and family and that can give you the support that you require.

If you have questions or concerns regarding your fertility or the way in which your fertility may be affected due to a diagnosis, environmental factors, or other health concerns, do not hesitate to schedule a consultation with one of our fertility experts to assist you in selecting the right path for you.