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Oncology Fertility Preservation

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Intrauterine Insemination (IUI) is a type of fertility treatment where specially prepared sperm is placed directly into a woman’s uterus using a thin catheter.
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Oncology Fertility Preservation

What it is ?

Oncology Fertility Preservation refers to a set of medical procedures designed to protect and preserve fertility in cancer patients (men, women, and children) before starting cancer treatments such as chemotherapy, radiotherapy, or surgery.
Many cancer therapies, while life-saving, can cause temporary or permanent infertility by damaging eggs, sperm, or reproductive organs. Oncology fertility preservation ensures that patients have the option to build a family in the future, even after aggressive treatment.
It is considered a crucial part of oncofertility care, which bridges oncology and reproductive medicine.
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Why is It needed ?

Cancer treatments can affect fertility in several ways:

  • Chemotherapy : Damages rapidly dividing cells, including sperm and eggs. Some drugs can lead to premature ovarian failure in women or reduced sperm production in men.
  • Radiotherapy : Radiation near the pelvis or abdomen can destroy eggs/sperm and damage the uterus or testes.
  • Surgery : Removal of ovaries, uterus, or testes results in permanent infertility.
  • Stem cell / Bone marrow transplants : Require very high-dose chemotherapy and sometimes radiation, almost always causing infertility.

When it is considered ?

  • Before starting chemotherapy, radiotherapy, or pelvic surgery.
  • In patients with cancers that are known to affect reproductive organs.
  • In children and adolescents who will undergo cancer treatment.
  • In patients with a family history of hereditary cancers (e.g., BRCA mutations), where risk-reducing surgeries may be considered in the future.
  • Cancer treatments must start quickly, and other fertility options may not be possible (e.g., ovarian tissue freezing instead of egg retrieval).
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Types

Oncology fertility preservation uses a variety of methods depending on age, gender, time available, and health status:

For Women

Egg Freezing (Oocyte Cryopreservation)

  • Mature eggs are retrieved, frozen, and stored for later IVF.

Embryo Freezing

  • Eggs are fertilized with sperm and embryos are frozen.

Ovarian Tissue Freezing

  • Ovarian cortex strips are frozen and reimplanted later.

Ovarian Suppression with Hormones (Experimental)

  • Drugs like GnRH agonists may temporarily “shut down” ovaries to protect eggs during chemotherapy.

Ovarian Transposition (Surgical)

  • Ovaries are surgically moved away from radiation fields.

For Men

Sperm Freezing (Semen Cryopreservation)

  • Collected before treatment, frozen, and stored.

Testicular Tissue Freezing (Experimental)

  • In boys before puberty, testicular tissue containing sperm precursors is preserved for future use.

For Children/Adolescents

  • Ovarian and testicular tissue cryopreservation are the only options, since they do not yet produce mature eggs or sperm.

Step Process

Procedure

For Women

Step 1 : Assessment
  • Counseling with a fertility specialist.
  • Ovaries stimulated with hormones for 10–14 days.
  • Eggs collected through a minor surgical procedure.
  • Eggs frozen directly, or fertilized with sperm to create embryos, or ovarian tissue surgically removed and frozen.

For Men

Semen Collection

  • Sperm collected through masturbation or surgical extraction (PESA/TESA if needed).

Cryopreservation

  • Stored in liquid nitrogen for long-term use.

For Prepubertal Patients

  • Surgical removal of ovarian/testicular tissue, freezing, and storing until future use.

Benefits

  • Provides hope and reassurance to cancer patients that parenthood is possible post-treatment.
  • Offers a wide range of options suited for different ages and medical needs.
  • Helps restore not just fertility, but also hormonal function in women through ovarian tissue transplantation.
  • Gives psychological comfort during cancer treatment, reducing anxiety about losing fertility.

Results & Success Rates

  • Women : Egg and embryo freezing are well-established, with good survival and pregnancy rates after thawing. Ovarian tissue freezing has led to over 200 live births worldwide and continues to improve.
  • Men : Sperm freezing is highly effective, with survival rates above 90% after thawing.
  • Children/Prepubertal patients : Still experimental, but early studies show promise in restoring fertility later in life.
  • Timing is critical : Success rates are much higher when fertility preservation is performed before cancer treatment begins.