To Freeze or Not to Freeze? – That is the Question
Published May 2021
Some of you may have heard about preserving your fertility or wondered whether it’s possible to stop the fertility clock from ticking. In this blog, we’ll explain a bit about the reasons behind why people might opt for preserving their fertility.
Fertility preservation is the general term used to describe procedural options that provide a patient with an opportunity to postpone having children until a later time. It is useful when individuals are faced with the risk of potentially losing their fertility due to increasing age or for medical reasons.
Why do people decide to Preserve their Fertility?
Nowadays, men, women and couples may want to preserve their fertility for a variety of reasons, which fall into two main categories; social reasons and medical reasons.
A few years ago, only patients about to undergo treatments for certain diseases and conditions were offered the opportunity to freeze their eggs or sperm, but now the wider populous can decide whether the option is suitable for them, but where this is considered, patients will need to seek private care as treatment for social reasons is not currently available via the NHS.
We’re not all predisposed to start a family at the same time. Some of us might want to delay starting a family because we haven’t met the right person yet, perhaps you don’t feel financially stable or not emotionally ready. Some of us are propelled by an urge to pursue a career or enjoy a current freedom that enables us to pursue new adventures on our own terms. But none of this necessarily means that we don’t ever want to start a family. It just means you don’t wish to consider it ‘right now’.
When this is the case, advances in fertility science and vitrification procedures, not previously available to non-medical patients, now offer us a scientifically viable option to preserve our eggs, sperm, embryos and even reproductive tissues to secure a biological family in the future.
When individuals are about to undergo some types of cancer treatment, they may want to consider preserving their fertility as some of the medications used can cause infertility, especially in high doses. This is particularly important for young children, as treatments can affect their reproductive development.
The common reasons individuals may be offered fertility preservation for medical reasons are:
- They’re about to undergo chemotherapy
- They’re about to undergo radiation therapy
- They’re starting hormone therapy
- They’re about to undergo reconstructive surgery
- They have a genetic condition which may decrease their fertility
Generally, individuals who are having treatment for medical reasons, can undergo their preservation pathway with the NHS but when it’s purely a lifestyle choice, this option isn’t available and you will need to seek private treatment.
In all instances, it’s important to note that fertility preservation can be completed in a relatively short amount of time, which enables the patients to continue to undertake treatment for cancer or other conditions within a reasonable timeframe.
Types of Preservation
Women either undergoing treatment that might affect their fertility, for example, a cancer pathway, can choose to freeze their oocytes [eggs] but if they are in a sound relationship, they may wish to decide to freeze their embryos instead as embryos are more likely to survive the thaw process than eggs. Once thawed, success rates are comparable with fresh embryos during an IVF treatment.
The process is relatively straight forward. Women will undergo the first part of an IVF cycle which involves taking medications to stimulate the ovaries to produce eggs. The woman is then sedated whilst her eggs are collected. The eggs are fertilised with her partner's sperm using IVF or ICSI depending on the quality of the sperm. The fertilised eggs are then checked for viability and frozen in special tanks of liquid nitrogen in a process called vitrification. They are stored for 10 years but this period can be extended in special circumstances for up to 55 years. The length of time they are frozen does not affect the quality of the embryos.
It is important to note the legal requirements of embryo preservation. Both partners will be required to sign forms providing their consent. If either party withdraws consent, at any time, your provider is legally obligated to thaw and dispose of your embryos.
Egg freezing is a singular party choice. The woman will undergo the first half of an IVF cycle, including taking medications to stimulate her ovaries. Her eggs are collected under sedation and immediately frozen in a tank of liquid nitrogen. When a woman wishes to use the eggs, they are thawed and those that survive are injected with sperm. A fertilised embryo is then transferred to the woman’s womb. It may be necessary to take special medications prior to embryo transfer to fully nourish the womb lining to develop a natural endometrium before a transfer.
Depending on your age and ovarian reserve, you may be recommended to have more than one cycle of treatment to ensure you have sufficient good quality eggs in preservation.
If you are going to undertake egg freezing prior to cancer treatment, it is important to discuss this with our oncologist.
If you are considering freezing your eggs, we have developed an online learning platform which provides you with all the information you need to be aware of before deciding to proceed. LINK
You may want to consider sperm freezing if:
- You have a condition, or are facing medical treatment for a condition that might affect your fertility
- You are considering having a vasectomy and want sperm available in case you change your mind about having more children in the future
- You have a low sperm count or the quality of your sperm is deteriorating
- You have difficulty producing a sperm sample on the day of fertility treatment/you may not be around at the time of treatment e.g. if you work away a lot
- You are at risk of injury or death ie. You serve in the Armed Forces
- You are a male transitioning to a female you may want to preserve your fertility before you start hormone therapy or have reconstructive surgery, both of which can lead to the partial or total loss of your fertility
It should be noted that using frozen sperm during IVF is just as successful as using fresh sperm. However, not all sperm survive the thawing process. The standard period for storage of sperm is 10 years but this can be extended to 55 years in special circumstances.
Using your sperm in treatment will require it being thawed as part of an IVF procedure where your pathway may include insemination, IVF itself or ICSI [intracytoplasmic sperm injection]. Your Consultant will discuss the options with you when you meet to proceed.
For information on Fertility Preservation services offered by IVF Matters - click here: https://ivfmatters.co.uk/pages/fertility-preservation-treatment