What fertility preservation options exist for women with a malignancy?

Cancer treatments, such as chemotherapy, hormone therapy, and radiation, can cause significant damage to the ovaries. This damage may lead to a reduced ovarian reserve (the number of eggs available), premature ovarian insufficiency, or delayed childbearing ³⁶. Because survival rates for many cancers have improved significantly, fertility preservation has become an important part of managing care for women of childbearing age ³.

What the research says

Several techniques exist to help protect reproductive health before or during cancer treatment. Validated methods include the cryopreservation (freezing) of oocytes (eggs) and embryos ⁵⁶. These are established methods used to preserve fertility for patients facing gonadotoxic therapies, which are treatments that can harm the ovaries ⁵.

Other options include ovarian tissue cryopreservation and ovarian suppression. Ovarian suppression often involves using GnRH analogs during chemotherapy to protect the ovaries from damage ⁵⁶. While oocyte and embryo freezing are considered validated techniques, ovarian tissue cryopreservation is sometimes categorized as an experimental technique depending on the clinical context ⁵⁷. These options are particularly relevant for patients at high risk of infertility, such as those with BRCA mutations who may face early medical interventions or intensive treatments ⁵⁷.

What to ask your doctor

• What specific cancer treatments (chemotherapy, radiation, or hormone therapy) will impact my ovarian reserve?
• What are the validated options for egg (oocyte) or embryo freezing available to me?
• Is ovarian tissue cryopreservation an option for my specific situation?
• Can we discuss using GnRH analogs during chemotherapy to protect my ovaries?
• How soon do I need to make decisions regarding fertility preservation before starting treatment?