This fast-growing field of oncofertility combines the specialties of oncology (cancer), reproductive endocrinology (reproductive medicine addressing hormonal functioning), and assisted reproductive technologies. “Utilizing this approach, cancer patients can preserve fertility by freezing and storing their sperm or eggs to later be used in combination with fertility treatments such as in vitro fertilization (IVF), explains Jason St. Pierre, PhD, HCLD, director of Kettering Reproductive Medicine on the campus of Kettering Medical Center in Kettering.
The need for oncofertility services arises due to the potentially harmful effects of cancer treatments such as chemotherapy or radiotherapy, which can temporarily — or permanently — stop a female’s ovaries from properly functioning and may impair sperm production in the male’s testes. Dr. St. Pierre says an experienced fertility and reproductive medicine practice can offer fertility preservation services, including egg and sperm freezing, to patients who will receive chemotherapy, radiotherapy, or other treatments that could negatively impact reproductive health.
A recent advancement in the field of assisted reproductive technology has expanded the fertility preservation options for female cancer patients. This process, known as egg vitrification, has resulted in more than 2,000 births worldwide. “Vitrification is a new and improved method of cryopreservation or cell freezing that instantly freezes eggs and prevents ice crystal formation,” explains Dr. St. Pierre. “Because there is no ice crystal formation, there is a decreased risk of damage to the egg cell and higher survival rates. The success rate for conception also increases when these eggs are used with IVF.”
Dr. St. Pierre says female patients wishing to have their eggs frozen meet with a reproductive endocrinologist, or fertility specialist, to develop a treatment plan in coordination with the patient’s oncologist. The patient will follow an ovarian stimulation program and upon completion will go through a surgical collection procedure to retrieve the eggs. Then the eggs will undergo vitrification and will be frozen and stored until needed for use in a future IVF cycle.
Dr. St. Pierre says fertility preservation services also are available for male patients. Chemotherapy or radiotherapy for cancer and other diseases could potentially impact future fertility by disrupting the normal processes of sperm production. Male cancer patients can enhance their future reproductive potential by freezing sperm or surgically retrieved testicular tissue prior to cancer therapy. These samples are stored until they are needed for use in an assisted reproductive treatment.
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