Female fertility preservation

 
 

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Some chemotherapy treatment causes infertility by eggs  in the ovary. The may be associated with a loss of function of the hormone producing cells and cause an early menopause. This may be temporary or permanent, depending on the drugs you are having.

Store fertilized eggs  It is sometimes possible to store fertilized eggs  for later use should your fertility not fully recover after treatment. In reality this is very rare for a number of reasons:

  • The process takes several weeks and chemotherapy cannot  usually be delayed that long.
  • High doses of hormones have to be taken by the woman and many tumour such as breast cancer would grow and spread faster during this time.
  • A consenting male partner has to be available at the time.
  • This facility is not available throughout the NHS and may only be available privately 

Ovarian tissue storage In some areas of the country, it is now possible to store ovarian tissue (which contain unfertilised eggs).  It then may be possible to extract these eggs at a later date, fertilise them with sperm and implant them into the womb. Well that's the theory! In fact, this is an experimental procedure although in September 2004 a patient from Holland successfully achieved a pregnancy and healthy baby with this technique. Current, however, it is extremely difficult to extract the eggs and fertilise them and success rates are so low that this make  the procedure impractical. However, with rapid advances in this field of medicine in the future it may be possible to achieve this. It is therefore not unreasonable to store ovarian tissue  now in the hope that by the time you want to have a baby the technology would be available - it must be remembered that there is no guarantee that this will be the case.

Very few areas of the country will provide this service. Furthermore, although the removal of the ovarian tissue and storage is available on the NHS, any subsequent fertility treatment has to be paid for privately. Ask your doctor which is the nearest fertility clinic to you.   For example in the Cambridge and Bedford Area this service  is provided by The Bourn Hall Clinic, Bourne. 

What will happen Many doctor may be unsure what to do as this is a very new procedure and is experimental. Here are the steps required:-

Your physician contacts a fertility clinic and refers you for a consultation. Provided you are eligible, a number of tests are performed as routine including hepatitis B and HIV in all cases. 

Your physician needs to decide whether your cancer treatments can be delayed for ovarian storage.

A local gynaecologists will perform a laproscopic removal of part of one ovary. This requires a general anaesthetic as a day case. Three small cuts (less than 1 cm) are made in the abdomen and the surgery inserts a flexible optical tube. This surgery is usually as a day case. There should be mild abdominal discomfort only for 1-2 days after this procedure.

After the surgery , the section of ovary needs to be taken to the fertility clinic within 2 hours, which may not be in the same hospital. The best way of achieving this is often to organise a relative to take it.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.


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