Our team works collaboratively with other providers and facilities to offer fertility preservation options for females who have started menstruating (having periods). We can explain your fertility preservation options, including potential risks, costs and likelihood of success, and connect you with knowledgeable specialists. We can also explain experimental options that may be available for young girls who have not started menstruating.
Additional discussion and further details of each option can be provided during fertility team consultation.
Some patients opt to use medications to try to protect the ovaries (and future eggs) from gonadotoxic treatment injury. The outcomes (return of menses and /or pregnancy after these treatments) are varied in medical literature.
If a patient requires pelvic radiation during cancer therapy, surgery to move the ovaries away from the field of radiation (oophoropexy or ovarian transposition) may prove beneficial.
Oocyte Retrieval and Preservation
Stimulating the ovaries with hormonal medication to make a lot of eggs at one time, retrieving those eggs through an office-based procedure and freezing the eggs for future use is a strategy to help preserve young women’s fertility when ovaries are at risk of injury or early failure. This is no longer considered experimental by leading medical organizations and has been endorsed by the American Society of Reproductive Medicine as an intervention that should be offered to all pubertal girls and women at risk of loss or reduction of fertility due to gonadotoxic treatment.
Excellent results in stimulating the ovaries and freezing the eggs in girls and young women have been reported; however, the data on actual pregnancies or live births after this intervention is much more limited. Potential disadvantages include cost and delaying treatment for up to 14 days to obtain the eggs. With oocyte preservation, the male partner can be identified at a later date.
Freezing embryos has been done for a longer time and with more success than freezing eggs. This intervention may be applicable for patients who have already chosen a male partner. The patient receives hormones, which stimulate the ovaries to make numerous eggs at once. Those eggs are retrieved through an office-based procedure and fertilized with sperm, and the resulting embryos are frozen for later use.
Ovarian Tissue Preservation
This experimental procedure involves surgically removing part of the ovary and storing it for later use. This is currently the only option for girls who have not yet started their periods, and is being done across the country at a limited number of institutions as part of research protocols. If you want to pursue this option, we can connect you to these centers.