In 2012, about 80,000 new cases of cancer were diagnosed in women of reproductive age in the USA. The American Society of Reproductive Medicine (ASRM) and the American Society of Clinical Oncology have put forth official guidelines recommending that patients be counseled about the effects of cancer treatment on fertility and preservation options.
Radiation therapy and chemotherapy pose a high risk of damage and toxicity to the ovaries. Strategies for fertility preservation prior to cancer treatment depend on a patient’s age, the type and urgency of treatment. Embryo and oocyte cryopreservation are the two established methods of fertility preservation offered through assisted reproduction technology (ART).
Embryo cryopreservation, whenever possible, is the gold standard. The ideal is to freeze by vitrification at the blastocyst stage (day five post fertilization), a method that we have introduced in the USA in 1988. Vitrification is a technique in which freezing occurs very rapidly with liquids nitrogen and the embryo is solidified into a glass-like state. At SMFI, the success rate with frozen/thawed blastocyst embryos is just as high as with fresh transfers.
Mature oocyte cryopreservation, also by vitrification, is an alternative option for women who do not have partners or who are not ready for conception. Until recently, oocyte freezing was considered an experimental procedure. However in October 2012, SARM published an official guideline stating that it can no longer be considered experimental and can be recommended based on significant improved outcomes. Servy Institute of Reproductive Endocrinology (S.I.R.E) established a program of oocyte cryopreservation in February 2012 with three proven successes in the first five attempts.