Starting a family is a deeply personal decision, and, due to several reasons, not everyone is ready to become a parent right away. Fertility preservation offers hope and flexibility to individuals or couples who wish to delay parenthood due to medical reasons, personal goals, or life circumstances. With today’s medical advances, it’s possible to protect your ability to have children in the future.
In this article, we shall briefly examine the numerous fertility preservation options that are now available, the procedures involved, along with the benefits and risks that need to be understood before proceeding with this important decision. Understanding these options is crucial in making informed choices about your reproductive health, ensuring that you are prepared for future possibilities when the time is right.
Fertility preservation for women and men refers to a series of medical procedures that harvest and save eggs, sperm and embryos for future use. This measure is taken to delay parenthood till a more appropriate time. Fertility preservation procedures are becoming increasingly common as they offer a reliable way to safeguard one’s ability to have biological children later on in life.
People choose fertility preservation for different reasons. Here are the typical reasons behind opting for fertility preservation:
Fertility declines as people get older. People who want to delay having kids till they are in their late thirties or forties should opt for appropriate fertility preservation procedures. This will ensure that they are able to become parents despite their advanced age.
Many people delay parenthood due to personal issues. Unmarried people who haven’t found a suitable spouse, professionals who are focused solely on their careers, etc., can opt for fertility preservation so that they can become parents at an appropriate time.
A few reproductive health issues, such as low sperm count in men or uterine fibroids in women, could impact the chances of successful conception. Egg and sperm harvest and preservation can be quite useful in such cases.
Certain diseases that don’t even directly affect the reproductive organs could have a long-term impact on fertility. Autoimmune diseases such as lupus, genetic disorders like myotonic dystrophy, etc., could ultimately lead to a loss of fertility and severely impact the chances of a successful pregnancy.
Very often, medical procedures and treatments also diminish the chances of successful conception. Cancer patients undergoing chemotherapy or radiation therapy could end up sterile.
Fertility preservation is needed for individuals who are opting for gender reassignment surgery, as it will help them become parents once they are ready.
People on career paths that put considerable risk on life and health, such as military personnel, industrial or nuclear power plant personnel, etc., could benefit from egg, sperm and embryo preservation procedures.
Fertility preservation procedures vary based on a person’s biological sex, as the methods for preserving eggs are different from those used to preserve sperm.
In this section, we shall take a look at the typical fertility preservation techniques for women.
Egg freezing for fertility preservation is one of the safest medical procedures for delaying parenthood. During the procedure, the eggs are harvested from the ovaries and frozen for later use. Hormonal injections gently stimulate the ovaries to collect a healthy number of eggs. This helps produce multiple eggs instead of the single egg typically released during a natural cycle.
The process is closely monitored through regular scans and blood tests. After about 10 to 12 days of stimulation, a final injection is given to mature the eggs. Around 36 hours later, the eggs are collected under sedation by using a thin needle inserted through the vagina into the ovaries.
Mature eggs are then frozen using a fast-freezing method called vitrification, which helps protect them from damage. These eggs can now be stored safely for many years. When ready to use, the eggs are thawed and then fertilised using a technique called ICSI (intracytoplasmic sperm injection). The resulting embryo is transferred to the uterus for potential pregnancy.
It must be noted that the best age to freeze eggs is between the ages of 25 and 35.
In some cases, a couple may choose to freeze embryos for future use. This involves stimulating the ovaries, retrieving the eggs, and then fertilising them with sperm in a lab to create embryos. These embryos are then frozen instead of the eggs. Embryo freezing has a slightly higher success rate compared to egg freezing.
For women or young girls undergoing cancer treatments, ovarian tissue freezing offers a chance to become pregnant once they have successfully overcome their illness. This procedure involves removing the ovarian cortex, the part of the ovary that produces the eggs, and then freezing and storing it. In order to get pregnant, this tissue can be transplanted back to the body.
Radiation therapy can drastically impact fertility. One way to ensure the ovaries and fallopian tubes are safeguarded is by repositioning them. During this procedure, one or both ovaries and fallopian tubes are surgically removed from the pelvic region and attached to the wall of the abdomen, thus ensuring that they are far away from the radiation field. This procedure has a few drawbacks. The ovaries and fallopian tubes cannot be moved back into their original position, and thus, assisted reproductive technology (ART) will be required to get pregnant. Another drawback is that the ovaries and fallopian tubes may be exposed to some radioactivity despite being located elsewhere.
Another technique that’s being used to protect ovaries from the radiation during cancer therapy is radiation shielding, whereby the ovaries are protected by a lead shield.
Now, let’s briefly examine the typical fertility preservation techniques that are used for men.
Sperm freezing is one of the most commonly used fertility preservation techniques. It is a simple and non-invasive process whereby sperm is collected from the semen ejaculated by men and then frozen and stored at a fertility centre.
This procedure is used in situations where it is not possible to collect sperm, such as in the case of prepubescent males or men suffering from azoospermia (lack of sperm). A small piece of testicular tissue is removed through a minor surgical procedure and frozen for future use. This tissue may contain early-stage sperm cells that could later be used to help achieve pregnancy.
Men undergoing radiation therapy to treat cancer may wear lead shields to protect their reproductive organs from radioactivity.
Fertility preservation, despite its many advantages, poses several risks. These need to be understood properly before making a decision.
● Infections or abnormal bleeding may occur due to the egg retrieval procedures.
● The ovarian stimulation process may lead to abnormally elevated levels of estrogen. This could cause blood clots or even estrogen-dependent cancers.
● Ovarian hyperstimulation syndrome (OHSS) is a potential complication of ovarian stimulation therapy.
● As mentioned earlier, the ovarian transposition procedure has several drawbacks. Apart from those, this procedure could result in the formation of ovarian cysts.
● To become pregnant after fertility preservation, IVF will be required. However, this could lead to premature delivery, multiple babies, ectopic pregnancy, miscarriage, etc.
Fertility preservation is a remarkable technique that ensures people do not miss out on the joys of parenthood. This procedure can help them successfully conceive their child later on in life when they are most comfortable.
