OncoFertility
How to preserve fertility during treatment?
Oncofertility means ensuring, before treatments start, that after they finish the woman still has the option to get pregnant. This is particularly important when the cancer treatment leads to premature menopause and the inability to conceive naturally. Preserving fertility upon receiving any cancer diagnosis, not just breast cancer, is crucial. Studies show that women who were able to preserve their fertility endure cancer treatments better and enjoy a better quality of life afterwards.
Did you know that…?
- Every year, around 18 000 women in Poland suffer from breast cancer, and 68 000 women have been diagnosed with breast cancer within the last five years. The incidence of breast cancer, especially in women aged 20-49, has doubled within the last three decades.
- Although cancers have a worse prognosis in young than in postmenopausal women, around 77% of them survives over 10 years after the diagnosis.
Preserving fertility – how to proceed?
Mature egg freezing
With an oncologist’s consent women may undergo an ovulation induction, which lasts between 10 to 12 days. During that time, patients take gonadotropins to stimulate the growth of the ovarian follicles, and the egg cells in them. Once the cells have matured, they are harvested and frozen. Ideally at least 8-15 eggs should be frozen. The more eggs are frozen, the better the chances of getting pregnant. In Poland, the freezing eggs is not a reimbursed procedure. It cost between 4,000 to 6,000 PLN (including hormonal stimulation, medication and puncture).
The eggs may also be fertilised once the cancer treatment ends. They are then thawed and fertilised with the partner’s sperm. Embryos are formed, one (sometimes two) of which are transferred into the uterine cavity on the third or fifth day of culture. The remaining embryos are frozen. The chance of a successful single embryo transfer is between 20 and 40%. Be careful: before deciding to freeze your eggs or embryos, be aware that in the event of the patient’s death, the eggs may be destroyed, but the embryos remain frozen indefinitely or may be put up for adoption.
Embryo freezing
If the patient is in a relationship, the embryos may be frozen. Frozen embryos give a better chance of getting pregnant than frozen eggs. Egg fertilisation occurs immediately after they have been harvested, even before the treatment begins.
Ovarian tissue freezing, or tissue cryopreservation
This is a new method involving a laparoscopic harvesting of the ovarian tissues, that is subsequently adequately frozen. Once the cancer treatment ends, the tissues are implanted in the pelvic peritoneum or in an ovary. The patient may get pregnant by insemination or through hormonal stimulation. Women who consider choosing this method should meet the following, so-called Edinburgh, criteria:
- under 35 years of age
- no children
- no metastases in ovaries
- no past chemotherapies
- at least a 5-year survival rate
