Medically indicated fertility preservation

Dr Richa Jagtap, Clinical Director, Consultant Reproductive Medicine, Nova IVF Fertility talks about the fertility preservation technologies

As we all know a woman’s fertility is finite. She is most fertile in younger age group like 20-30 years. Egg numbers and fertility potential declines steadily with age. No new eggs grow through the lifespan, and women use eggs every month from the start of menses, till such time that she is into the mid to late thirties and the egg reserve depletes at a faster pace.

By the time a woman reaches her forties, the best eggs have finished, and leftover eggs give a poorer chance of healthy pregnancy. Social Egg freezing helps a woman to preserve her fertility during her best fertile years when she may not be able to commit to conception. Egg freezing is more than a social choice for many women. It comes as a boon to women with cancers who need to undergo chemotherapy/surgery which is known to seriously hamper fertility.

Egg freezing is also advised for single women with severe endometriosis and some forms of genetic conditions where there is a rapid depletion of good eggs with time. We know the egg reserve keeps diminishing with age, but conditions like endometriosis, ovarian surgery, certain forms of immune disorders can also damage and deplete ovarian reserve. These women may benefit by fertility preservation as they may have otherwise depleted their egg reserve by the time they can plan starting a family.

Women who have been diagnosed with cancer and are advised chemotherapy or radiotherapy are definitely at risk of severely diminished, sometimes complete depletion of egg reserve post these treatments. The survival rates following early detected cancers is improving, especially for young population.

Once cured of cancers, this group of survivors will definitely look at a good quality of life and that also included reproductive health. Hence fertility preservation in form of egg freezing is offered to this group of women, before they undergo the cancer therapy.

The frozen eggs is of course not a guarantee to conception but it greatly enhances the chances for conception, which are otherwise minimised due to cancer therapies. The eggs in a woman’s body can be harvested by ovarian stimulation, retrieved in a simple day care procedure and cryopreserved by the advanced vitrification process. These eggs can be maintained for 5 years or more. The duration of storage does not hamper the egg quality. The eggs can be later used for the process of IVF/ICSI conception with all the good prognosis of a young woman’s age.

The process and procedure should be well understood, and it’s always best to have at least 10-12 eggs frozen to give a fair shot at conception. It’s worth noting that all eggs do not fertilise and form embryos and all embryos do not give pregnancy.

For cancer patients, the ovarian stimulation protocols for egg freezing are designed keeping in mind the safety and response of certain forms of cancers to hormones. They are offered to women with good outcomes and survival rates post cancer therapy. Multiple studies done across the continents have assured us about the safety of these protocols and it has been seen that undergoing ovarian stimulation to freeze eggs does not adversely impact the cancer outcomes or survival rate of these women.

The science has given a choice and option to women to preserve their fertility in the face of disease affecting their chances of reproduction. It’s imperative that women are aware of these options and are able to discuss the same with their care providers. It will definitely contribute to a happier and better quality of life for them.