Social Embryo Freezing – Jannali, New South Wales

Fertility Preservation for Women Egg Embryo Freezing

There are a number of different establishedand emerging techniques for fertility preservation in women. The one that is most establishedis cryopreservation of the embryos. This has been done for many years and we have greatexperience with this as do other centers around the world. Embryo freezing requires generallythat the woman undergoes an IVF cycle. The eggs that are collected in the IVF cycle arethen fertilized with either her partner's sperm or donor's sperm, and the resultingfertilized eggs, which are now called embryos, are frozen to be used at a later date. Thenumber of embryos that are needed depends on the woman's age. In general, the olderthe patient, the more embryos she should freeze

to ensure that she has a good chance of achievingpregnancy with those embryos. In the recent couple of years, egg freezing has become moreand more widely utilized and we've gained a lot of experience with this as well. It'snow considered no longer to be experimental in the setting of cancer or where a womanis facing therapy medical treatments which will impair her ovarian funcation. It is stillconsidered experimental for social fertility preservation, although it is being used forthat widely including in our center. Egg freezing is somewhat different from embryo freezingbecause it's a great option for women who don't have a spouse and who are not willingto fertilize their eggs with the sperm of

a sperm donor, but it has it's limitationsas well. For example, eggs are much more difficult to freeze than embryos because an egg is abig cell, whereas an embryo consists of many small cells and it's very technically difficultto freeze a big cell that's an egg compared to the embryo. So, in general, women who arelooking to do egg freezing, whether it's for medical reasons or for social reasons, we'llneed to freeze more eggs than women that are freezing embryos. Another great option forwomen who've newly been diagnosed with cancer or another serious medical problem who needtherapy very quickly for this, is ovarian tissue freezing and CHR has recently startedoffering this procedure. This is still considered

experimental, but there have been numerouspregnancies now documented after that tissue has been retransplanted into patients whohave undergone chemotherapy, then subsequently went into an early menopause. The tissue wasthen retransplanted back into their ovary and they regain, 90% of patients in most studies,have regained ovarian function and resumed their monthly cycles. And there have beenabout 40 or 50 pregnancies now documented around the world from following this procedure,so we are excited to offer ovarian tissue cryopreservation. This is actually a greatoption for many women who don't have necessarily the time to freeze eggs before starting chemotherapyor radiation therapy because ovarian tissue

freezing can be done literally the next dayafter I meet the patient. We go to the operating room, take out of a portion of the ovary,and the patient can start treatment right away. The other group of patients for whomovarian tissue freezing makes a lot of sense is for kids because really, egg and embryofreezing is not an option for them. We're not going to be able to retrieve eggs fromthese patients. So, for a young girl who hasn't reached puberty yet, this is really the onlyoption at the moment to preserve her fertility before she undergoes therapy that will potentiallydestroy her ovarian function. So, again this is a great option for a variety of differentsettings. Medical management of fertility

preservation has also been gaining a lot ofattention recently. This is mostly in women who are already undergoing chemotherapy orradiation. There are now medicines that can be given in parallel with our primary treatmentwhich can sort of suppress the ovaries and help preserve some of the ovarian reserveand egg supply and there have been a number of studies showing that these kind of medicationscan be effective in helping women to preserve their fertility while they are undergoingthese treatments for cancer. The last and probably most infrequently used fertilitypreservation approach is for women with gynecological cancers, and there are a number of differentof surgical mentalities that are used here,

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