All About Fertility Preservation Techniques

Having a child is a desire that many men and women have, but it is not always possible due to progressive loss of fertility over time or disease. Thanks to the latest advances, there is a wide range of procedures that facilitate fertility preservation.

Fertility preservation techniques

Because of today’s lifestyle, many people decide to delay becoming a mother or father. This situation makes fertilization more difficult, as the number and quality of oocytes and sperm decreases with age.

To prevent this loss and maintain fertility, there are currently several techniques in Assisted Reproduction.

  • Ovarian tissue freezing. It allows the preservation of thousands of ovarian follicles at a time. It is indicated for girls who are in the pre-puberty stage and those who cannot delay chemotherapy treatment.
    Ovarian function is usually restored 60 to 240 days after transplantation and lasts at least seven years. So this technique is effective in preserving endocrine function for a long time.
    There are low follicular survival rates after ovarian tissue cryopreservation, so this method is contraindicated in women over 40 years of age. There is concern about the potential for tumor cells in cryopreserved and transplanted ovarian tissue in patients with cancer, so it is also recommended to rule it out in case of leukemia, Burkkitt’s lymphoma, colon cancer, among others.
  • Oocyte vitrification. It is the best fertility preservation technique at present. Advances in technology show that this technique has similar levels of success to those achieved in fresh IVF cycles. In addition, it eliminates the need for the use of donor sperm in women without a partner, minimizes the ethical, personal and religious considerations that exist in embryo freezing, and provides great autonomy in terms of fertility.
    For the treatment to be effective, the ideal is to obtain as many metaphase II mature eggs as possible.
    In hormone-dependent cancers, although it has been seen that a brief increase in estrogen for two weeks does not affect tumor progression, we must associate aromatase inhibitors.
  • Embryo vitrification. For this procedure, in vitro fertilization must be performed and the embryos subsequently frozen. It has very good pregnancy rates, but does not provide autonomy in terms of fertility since the embryos generated will always belong to both members of the couple.
  • Semen freezing. Semen samples are cooled and preserved in liquid nitrogen, at -196ºC, with no time limit. The patient delivers a semen sample to the laboratory within 40 minutes of collection. An evaluation is made to certify that the specimen can be frozen and to indicate the number to be delivered for reproductive use.
    As occurs in some of the treatments for women, it is recommended for those men who will begin a treatment that will compromise or annul their reproductive capacity. Another function is the seminal donation either for sperm banks or in egg donation treatments. It is also applied in those couples in which the man is serodiscordant, that is, he is a carrier of HIV and a semen purification must be performed. It is also used in those patients who for other reasons
  • Freezing of testicular biopsy. It is performed when the patient cannot ejaculate or there are no spermatozoa in the ejaculate. It consists of obtaining spermatozoa by aspiration through a needle or small biopsy. Its function is to detect at what point sperm production is interrupted. Among the advantages are the low risk of suffering complications and its high tolerance.
    It is recommended for patients with absence of spermatozoa during ejaculation, azoospermia; deficient sperm segregation, oligospermia; and pathologies or variations that affect semen quality. In addition, for those patients with obstruction of the seminal duct and who wish, together with their partner, to become parents. In the latter case, it will be performed on the same day as the in vitro fertilization (IVF).
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Fertility preservation techniques: who are they recommended for?

They are recommended to all those patients who are expected to have a decrease in their fertility for any reason, which may be:

  • By external agents such as chemotherapy and radiotherapy in cancer patients or treatments for other diseases that affect fertility.
  • Due to the effect of age and then enters into what we call social vitrification of oocytes, freezing eggs in young women for a later reproductive desire.

Fertility preservation techniques: Risks

In principle, no, since in the case of hormone-dependent cancers, such as breast cancer, different treatments such as letrozole are used during ovarian stimulation. The remaining risks are the same that any patient has in an in vitro fertilization cycle, that is to say, the risks are minimal.

Fertility preservation techniques: care

Analyses will be requested prior to the treatment. Subsequently, no specific care is required other than rest for 24 hours after follicular puncture, i.e. egg retrieval.

For more information on fertility preservation techniques, please consult a specialist in Assisted Reproduction.

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