Fertility Preservation

What Is Fertility Preservation

Fertility preservation is a fairly new concept in reproductive medicine. The idea of preserving a patient’s current fertility status for future use is rapidly gaining exposure in the media, resulting in growing public interest in its utilization. Initially developed primarily for young patients of cancer and other diseases undergoing life-saving treatments that can cause irrevocable damage to reproductive function (medical fertility preservation), fertility preservation is a concept of “safeguarding” current reproductive abilities into the future by storing reproductive cells or tissues “out of harm’s way.”

CHR Explains

In recent years, so-called social fertility preservation, especially utilizing egg freezing, has rapidly gained popularity. In this application of fertility preservation, women delaying childbirth are trying to preserve their fertility of younger years into the future by freezing their eggs when they are young but not ready to start a family.

Medically indicated and social fertility preservation, however, constitute distinctively different ethical and practical concepts of fertility preservation, with their own distinct risk-benefit considerations. We need to discuss the two separately.

Medically Indicated Fertility Preservation

Here, patients face medical conditions or life-saving medical treatments which with great likelihood will “wipe out” gonadal functions of ovaries in women and of testes in men. Chemotherapy and radiotherapy are good examples. While potentially life-saving, they are also toxic to reproductive cells (eggs and sperm). With modern cancer therapies, more and more young patients overcome cancer and eventually return to a normal life. To maintain options of having biological children once cured of cancer, patients are now encouraged pursue fertility preservation. Whether the patient is male or female, the idea of fertility preservation in these cases is to store reproductive cells (or tissue) “away” from the harm of toxic treatments.

The alternative to medically indicated fertility preservation is life-long sterility with no way to have biological children, a devastating consequence for most. For this reason, medically indicated fertility preservation is no longer considered experimental, even though success is not guaranteed, and outcome statistics for the procedure are still insufficient. The ethical consideration behind this designation is that, whatever the results from fertility preservation, even if only minimally successful, it will be superior to virtually guaranteed life-long sterility.

Different methods of fertility preservation may be appropriate, depending on medical conditions and/or gonado-toxic treatments needed, as well as the patient’s personal circumstances. In some cases of gynecological cancers, use of specific surgical and medical treatment techniques can be used to avoid damage to vital reproductive organs.

What medical conditions are involved, which treatments must be started, and how soon, whether the patient has a committed life partner, how many children the patient might want to have in the future are all important questions to be considered. Open communications and close collaboration between patients, treating physicians and reproductive endocrinologists offering fertility preservation are, therefore, crucial.

Social Fertility Preservation

In many developed countries, women are increasingly delaying childbearing as they pursue higher education and career goals. With growing public awareness of female fertility declining with advancing age, especially after age 35, social fertility preservation has become an increasingly popular solution. By freezing eggs or freezing embryos when still young, women assure access to their youthful reproductive potential later in life, when they are ready to start a family.

Most women are single when pursuing social fertility preservation. They, therefore, usually prefer to freeze eggs . Increasingly, however, we see married couples who want to preserve their fertility. They frequently freeze embryos because embryo freezing is more predictable than egg freezing.

Considerations surrounding social fertility preservation differ from those of medical fertility preservation. Here, the certainty of sterility later in life does note exist. Therefore, the still limited amount of published data about the procedure and its outcomes, as well as the resulting uncertainties in risk-benefit analysis, mandate that social fertility preservation via egg freezing be considered still experimental. Embryo freezing, however, has for many years been considered an “established” procedure.

The Fertility Preservation Center at CHR

CHR established its Fertility Preservation Center (FPC) in 2008, when fertility preservation, whether for medical or social indications, was still in its infancy. Today, CHR is among only a small number of IVF centers licensed to cryopreserve (freeze) not only eggs but also ovarian tissue for this purpose.

Now under the leadership of Vitaly A. Kushnir, MD, CHR’s FPC has expanded its operations considerably, especially when it comes to medically indicated fertility preservation. Before assuming the position of Director of CHR’s FPC, Dr. Kushnir travelled to the Sheba Medical Center at Tel Haschomer in Israel, which is probably the leading center for fertility preservation in the world for young women requiring cancer treatments. Upon his return, Dr. Kushnir adopted many of the Israeli methods of fertility preservation for young cancer patients into CHR’s protocols.

CHR’s social egg freezing program has grown over the years even more rapidly. Recently, FPC announced a four-cycle egg freezing package, which offers significant cost savings to women who need multiple freezing cycles to accumulate large enough number of eggs/embryos.

CHR’s FPC offers a rare, comprehensive array of fertility preservation options for both medical and social reasons, for men, women and pre-pubescent children among U.S. fertility centers:

  • Embryo banking (freezing)
  • Egg banking (freezing)
  • Ovarian tissue banking (freezing)
  • Sperm banking (freezing)
  • Fertility preservation for children

Because of urgency in starting cancer treatments, medically indicated fertility preservation can often be an emergency situation. Access to the CHR’s FPC is available every day of the year, 24-7. If you need to consult a FPC physician urgently, please call 212-994-4400.

Read more about Fertility Preservation

Last Updated: November 15, 2014

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