Fertility preservation (FP)
WHAT ABOUT SOME EGGSURANCE ?
"We are made wise not by the recollection of our past, but by the responsibility for our future. – George Bernard Shaw" (George Bernhard Shaw)
Fertility preservation, as a medical procedure, was initially addressed for cancer patients who should undergo chemotherapy or radiation. Soon, it became obvious that fertility preservation could be used in more cases, for both interested men and women, particularly with regard to a woman’s oocytes. The form of FP depends, of course, on the medical circumstances. Ovarian tissue, oocytes, spermatozoa, testicular tissue and embryos can also be conserved.
In the context of social and cultural developments in society, the age of parents when a child is born is higher now than in previous times. Through FP as a medical method, men and women have the possibility of becoming their own donors at a later time. Thus, “social freezing” has become a must during the past years, especially for women who do not wish to stay apart because of a family. Nevertheless, it is clear that time is the worst enemy of their oocytes’ quality.
Other thoughts in favor of FP are related to the presence of autoimmune diseases, early menopause (POF in the family), or an operation that may have infected the function of the ovaries or the testicles or caused their removal.
A series of necessary tests is performed (regarding infectious diseases) to both men and women before FP is carried out.
Men can donate some sample sperm, which is kept in portions.
The procedure for women resembles that of a stimulation cycle but without an embryo transfer. A stimulation protocol is created after a thorough hormonal investigation. The woman must undergo 2–4 ultrasound controls. The oocyte retrieval occurs approximately 14–15 days after the start of the treatment (around the middle of her cycle).
Depending on the results, many cycles may take place. According to studies, 12 mature oocytes are necessary for a pregnancy, so women feel very well if they manage to ensure 20–30 oocytes, which correspond to 1–3 cycles.
The procedure is completed after the oocytes’ retrieval. Annual storage fees are charged, and the oocytes may eventually be “picked” by the woman; however, many years might pass (provided that legal age limits are observed). The oocytes will be fertilized with the sperm of the actual partner, and the resulting embryos will be transferred to the uterus.
In case the woman never does use her oocytes, perhaps because a natural pregnancy occurs, she can always donate or destroy them.
As a rule, it is recommended that oocytes be stored without being fertilized, i.e., one should store unfertilized oocytes and spermatozoa. For example, embryos frozen by a couple may be used only with both partners’ consent. Should this relation no longer exist, the embryos may not be used.
FP should preferably take place at an early life stage, ideally in the person’s 20s and 30s. Nevertheless, nothing ensures that the retrieved material will be viable at a later time and able to be fertilized, or that it can successfully start a pregnancy. However, improvements of new technologies have raised success rates over time.