Fertility Preservation

The preservation of fertility began to be developed as a result of observing that the treatments used against cancer, both chemotherapy and radiotherapy, produced sterility as a side effect in a not insignificant percentage.

[fusion_dropcap boxed=”no” boxed_radius=”” class=”” id=”” color=””]I[/fusion_dropcap]nfertility associated with oncological treatments was an adverse effect that was not important compared to the serious health problem that the patients presented. That is to say, it was “the least of it”. Fortunately this fact has changed and most doctors are aware of the importance of fertility for a young patient who has not had children or who has not completed offspring.

On the other hand, as a result of the socio-cultural changes we are experiencing, women seek job and economic stability before considering motherhood, but at the same time it is well known in our area that fertility declines with age. Where the other fertility preservation indication that has more and more followers has emerged is the so-called social indication.

It consists of the application of medical, surgical and laboratory procedures to preserve the reproductive capacity of both women and men, who for different health or social reasons are at risk of losing their reproductive potential.

Preservation of male fertility: Semen cryopreservation.

What does it consist of?
Semen cryopreservation is a technique that allows the maintenance of male gametes for a long period of time.

When is semen cryopreservation recommended?
This technique is especially recommended for all those men of childbearing age who want to preserve their fertility, either because they have to undergo medical treatment or by choice.

Semen cryopreservation is also useful for those patients who may develop azoospermia, due to a low sperm count, or for those patients who want to undergo a vasectomy and wish to preserve their fertility.

In all these cases it is recommended to use some method of fertility preservation, either semen cryopreservation or testicular tissue cryopreservation.

Testicular tissue cryopreservation is an alternative to semen cryopreservation whenever the latter cannot be performed. It consists of obtaining a portion of testicular tissue through a biopsy. These tissue fragments are cryopreserved and can be used when necessary through the most optimal assisted reproduction techniques in each case, usually ICSI.

How long do frozen semen samples last?
In principle, the sample can be stored in liquid nitrogen indefinitely and continue to be suitable for fertilization. For this to be possible, the spermatozoa are protected with a cryoprotective medium that allows the durability of the frozen samples in our fertility clinic.

Pregnancies have been obtained with samples that had been frozen for up to 15 years.

When is male fertility preservation indicated?

  • For medical reasons: for example before undergoing treatments that may cause male infertility, such as cancer treatment or a vasectomy.

  • In in vitro fertilization treatments (although a fresh sample is going to be used, having a frozen sample avoids some unforeseen events and creates greater peace of mind for the couple).

  • When male fertility is in danger due to a progressive deterioration of the characteristics of the spermatozoa due to a known or unknown cause.

  • When sperm counts are so extremely low that the accumulation of sperm from various ejaculates is advisable.

Preservation of female fertility: Vitrification.

What does it consist of?
Vitrification is a cryopreservation technique that can be performed on both embryos and oocytes. It consists of an ultra-fast freezing system that uses cryoprotectants that prevent the formation of ice crystals inside the cell. The process causes the cell to solidify. With this freezing system, survival rates are higher than 80 percent. In other words, in this way there are already oocyte banks

Who could be a candidate for this fertility treatment?
Those women who, for various reasons such as work commitments or lack of a partner, mainly see that they are celebrating their birthday and cannot find the time to be mothers. They are usually women who are clear that they want to start a family in the future but are worried about the passage of time. Could it be that when they want to be mothers they are no longer the right age?

How long can oocytes remain vitrified?
There are no time problems. Oocytes can remain vitrified indefinitely. It has not been observed that with the passage of time when devitrifying them their quality decreases.

When is female fertility preservation indicated?

  • To preserve fertility: Egg vitrification offers the possibility of combating the effects that the passage of time has on the reproductive system of women. Especially after the age of 35, one can speak of a deterioration that takes the form of:

    1. A progressive reduction in fertility due to aging of the ovaries.
    2. A progressive reduction in the chances that if pregnancy is achieved a healthy child will be born.

  • For this reason, this technique is indicated for young women between 30 and 35 years old without a partner or who simply want to voluntarily postpone their maternity.

  • For medical reasons: for example, before beginning cancer treatment that may cause infertility (chemotherapy and radiotherapy cause irreversible damage to the eggs).

  • For ethical-moral reasons: Egg vitrification offers the possibility of avoiding the freezing of embryos to those couples who, due to their beliefs and not for reasons, wish to be transferred, freezing the rest of the eggs (instead of the embryos as is done traditionally). conventional) for possible later use.

  • To increase the chances of pregnancy in women with low ovarian reserve.