Preservation of fertility in women with cancer
Written by:Currently, oncological treatments have improved and increased the life expectancy of cancer patients. When a young woman, who wishes to have her own offspring, has to undergo some of these treatments, she must be informed about the possibilities that this wish can not be fulfilled.
As has been the case with semen samples for many years, now, with the appropriate technology and knowledge, new strategies have been developed to preserve the reproductive capacity of women undergoing oncological treatments .
Oocyte cryopreservation
The cryopreservation of oocytes by vitrifying them is a technique validated in most laboratories, achieving survival and pregnancy rates quite close to those obtained fresh, ranging in general terms between 30-45%. For all these reasons it could be considered as one of the strategies of choice to preserve fertility in women who are diagnosed with different oncological processes .
At present we could say that in patients undergoing Assisted Reproduction techniques to preserve their fertility due to cancer, similar results are obtained in infertile patients .
The fact of preserving oocytes or embryos will depend on the age of the patient (only applicable if they have reached reproductive age), will of the same, the existence or not of a partner at the time of diagnosis of the disease and ethical considerations and legal (embryo generation).
Always keep in mind that there should be a good ovarian reserve when we propose the option of cryopreservation of oocytes / embryos, and therefore it is essential to perform at least one gynecological ultrasound to be able to perform this evaluation. The vitrification of oocytes will be considered as a good option to preserve the fertility of these patients if we obtain a minimum number of 10-12 oocytes, and should even offer the maximum number of possible cycles prior to the start of chemotherapy.
Get oocytes
In order to obtain oocytes / embryos, an average of 14 days of treatment prior to the start of chemotherapy is required , so it is essential to ask the patient the option of preserving their fertility from the first moment of diagnosis as it could delay the start of the oncological treatment.
Controlled ovarian stimulation to obtain oocytes / embryos can be initiated at any time of the menstrual cycle, requiring periodic analytical and echographic controls.
The oocytes will be obtained through an intervention called follicular puncture , which is usually done on an outpatient basis. It is carried out in an eco-guided way and under sedation, there should be no medical contraindication for the realization of it. Subsequently, the patient is discharged a few hours later, after the relevant assessment of the medical team.
Once obtained, the mature oocytes will be vitrified after their evaluation in the laboratory, or they will be inseminated with the semen of the couple, if the patient has chosen to freeze embryos, being finally these cryopreserved.
