There are several reasons for delaying fertility and recent technological advances have made it more accessible than ever before.
We have a Fertility Preservation program in place that involves freezing (cryopreservation) of sperm, eggs and embryos which can be thawed and used anytime in the future when the desire to achieve fertility is realized.
Cryopreservation of sperm has been available for decades and is the procedure of choice for preserving male fertility. The most common reason for this procedure is when treatment of a disease such as cancer involves the use of chemotherapy or radiation that could permanently destroy a man’s ability to produce sperm afterward. Another reason might be prior to vasectomy if the man wants to retain the possibility of fertility in the future if an unplanned situation might arise. Sometimes following a vasectomy reversal even if successful, sperm is often cryopreserved to guard against the possibility of the scarring down of the surgical site which could result in loss of the ability to recover sperm naturally. In all of these situations, the collection of several semen samples is all that is required and the sperm is divided into portions which are then frozen until such time as they are needed. Current methods of cryopreservation allow for excellent recovery of sperm after the thaw. Another method of fertility preservation is cryopreservation of pieces of testicular tissue. This is often performed instead of vasectomy reversal for those men who desire a less involved procedure and wish to retain the fertility limiting effects of the vasectomy following successful pregnancy. It is also used for men who have very low sperm counts (sometimes zero) when sperm is collected by ejaculation. In these cases, surgical removal of pieces of testicular tissue may be required to obtain enough sperm for fertilization of the eggs by Intracytoplasmic Sperm Injection (ICSI) and the unused pieces can then be cryopreserved for later use.
Cryopreservation of eggs is a process that has become very successful in the past few years. A new procedure called Vitrification allows us to recover over 90% of the eggs that are frozen with about a 75% fertilization rate when sperm are injected. This has therefore become the best option for single women who desire to delay fertility. The treatment of certain cancers with chemotherapy or pelvic radiation may result in permanent sterilization due to the damage imposed on the ovaries. For these situations, eggs may be retrieved and frozen prior to treatment and then thawed later when fertility is desired. Some women simply choose to delay fertility until they have found a partner to have children with or because of a busy career. In these situations, eggs are retrieved and frozen when the women are younger and the eggs are more likely to be genetically normal than when they later want to become pregnant. In both situations, the process of Vitrification insures that their future fertility is maximized.
Cryopreservation of embryos is the best choice for preserving fertility when a woman has a partner who can provide sperm at the time the eggs are retrieved. In situations requiring treatment of cancer for instance, once the eggs are removed from the ovaries they are immediately fertilized and the resultant embryos are then cryopreserved. The Vitrification process is used for embryo cryopreservation and has most recently been shown in our program to give pregnancy rates very close to those achieved when using fresh embryos. Cryopreserved embryos have been successfully used when thawed after 10 years in our hands, and there are reports of embryos leading to pregnancy after 20 years of storage.