Fertility Preservation

Ovarian function is not forever. Fertility naturally decreases with chronological age and it cannot be restored after the menopause and after some types of cancer treatment. Research shows that the 21st century is a time of significant population ageing and that women leave it too late before they decide to start a family. Both fertility physicians and scientists have given a great deal of attention to strategies to optimise fertility preservation methods in women, to ensure that preservation programmes are available, affordable and reliable. At the Reproductive Health Group we have the latest technologies and the multidisciplinary experties to assist you through the fertility preservation journey. Cancer patients can benefit for tailored support counselling and start treatment to freeze their eggs or sperm within days of the life-changing diagnosis.

What are the main causes of reduced fertility?

There are many factors affecting fertility. Age is one of them. The percentage of couples who are having children later in life is increasing. Demographic data indicate that the population is ageing. In the 1950s, couples had on average four children, whereas now, less than two. In 2050, more than 40 per cent of the world’s population will be over 65 years of age. On a global scale, the number of children is decreasing in countries in which the standard of living is increasing.

What causes a decrease in fertility?

Women want to get a degree, have a stable successful job and then start planning to have children for children. During these years women age and naturally fertility decreases. Out of the million egg cells which women are born with, they may use around 400 during ovulation between the age of 15 and 45. Every minute two egg cells die in a woman, and the older they are, the faster they die.

Apart from the natural fertility loss, there are also extenuating factors which may cause a radical decrease in fertility. For instance, chemotherapy and radiotherapy for cancer may impair fertility, some kind of surgeries may affect the reproductive organs function. Whenever possible women should be warned about the risks of infertility and options to preserve fertility should be offered.

What fertility preservation methods are used?

Like men have the option of freezing the sperm to preserve their fertility, women can freeze their mature eggs and also ovarian tissue as a form of fertility preservation. Thanks to vitrification, a special fast freeze method, the stored eggs have great potential to be used for in vitro fertilisation. More recently, techniques to freeze ovarian tissue have been developed and optimised. The method is used in those patients who cannot undergo controlled ovarian stimulation with hormones before the treatment due to the risk that the cancer may progress to a more advanced stage.

Do all cancer treatments cause infertility?

Not all cancer treatments leave women infertile. However, it is important that patients are fully informed of the risks and have realistic expectations. Young women diagnosed with cancer think about their life with the disease and are often talked in to the available treatments, but very seldom are counselled regarding their fertility potential if and when they recover.

How does cancer treatment affect fertility?

Cancer treatment affects the reproductive function of female and male patients. The longer the treatment and the stronger the doses the higher the risk of damage to the pelvic organs. Chemotherapy and radiotherapy destroy the rapidly dividing cancer cells and normal cells alike. They may damage or completely destroy both eggs and sperm. The effect could also be the same if some treatments take place away from the pelvis. For example, irradiation of the pituitary gland or other regions in the brain that produce hormones which control the function of the ovaries or testicles may cause infertility. Bone marrow and stem cell transplants, which usually require large doses of chemotherapy are also associated with a risk of infertility. Surgery to treat cancer may affect fertility potential and pregnancy rates both in women and men.