What are the fertility preservation options?
Freezing eggs is the procedure of choice in those that want to delay their child bearing due to social or medical reasons. The egg freezing procedure involves administering injections to stimulate the ovaries for around 12 days. Following this, the eggs are collected under sedation. The egg collection is a relatively non-invasive procedure, and carries minimal risks. The stimulation of the ovaries has been associated with a low risk of a complication referred to as ovarian hyper stimulation syndrome.
Sperm can be frozen for future use either in artificial insemination or other fertility treatments, or be donated. You may want to consider freezing your sperm if you have a condition or are facing medical treatment for a condition that may affect your fertility, or you have a low sperm count or the quality of your sperm is deteriorating, or if you have difficulty producing a sample on the day of fertility treatment.
After a cycle of IVF treatment, there may be a number of successfully fertilised embryos that you can store for your future use. The embryos need to be of good quality as poor quality embryos do not survive the freezing/defrosting process. Embryos can be frozen at various stages between the cleavage stage (day 2) to the blastocyst stage (day 5 or 6). They can be stored for up to ten years in the first instance.
A frozen embryo transfer gives you another chance of a pregnancy from the initial egg collection with a much reduced cost and without having to go through an egg collection again. You may be given some drugs to help build up the lining of the womb or you may have the embryos put back in natural cycle. You will have ultrasound scans to determine if you are ready for the transfer. At this time, the embryologist will warm the embryos. The embryo is transferred under ultrasound guidance using a soft catheter. Rarely, embryos may not survive the freezing/defrosting process.
Testicular tissue Freezing / Surgical Sperm Retrieval
In men with no sperm in their semen e.g. those who have had a vasectomy and later decide they want children, or in those who cannot ejaculate, such as men with spinal cord injuries, it is necessary to extract sperm surgically in order to fertilise eggs during IVF. Sperm obtained using any of these procedures will usually have poor movement and will need to be directly injected into each egg. This process is known as intracytoplasmic sperm injection (ICSI).
The three different methods of sperm extraction are
Micro-epididymal sperm aspiration (MESA)
Percuateous epididymal sperm aspiration (PESA)
Testicular sperm extraction (TESE)