What is Fertility Preservation?

Egg Freezing (Oocyte Cryopreservation)

Egg freezing is an option for individuals who want to utilize their current eggs at a later date. This can be helpful if they don’t have a partner, have personal or religious reasons, are seeking gender affirming treatment, or need medical treatment that might affect their ability to have children. 
 
The process starts with daily hormone injections for about 10-12 days. These help multiple eggs mature. During this time, doctors check hormone levels and use ultrasounds to see how the ovaries respond. The process will also require daily hormone injections. These help multiple eggs mature. During this time, doctors check hormone levels and use ultrasounds to see how the ovaries respond. Once the eggs are ready, they are collected in a short outpatient procedure using light anesthesia. A trained scientist, called an embryologist, then examines and freezes the eggs. Once the eggs are mature, they are collected in a short outpatient procedure using light anesthesia. A trained scientist, called an embryologist, then examines and freezes the eggs. It is important to note that not all eggs retrieved will be mature enough to freeze, and sometimes more than one cycle may be needed to freeze enough eggs for future use. Your doctor will recommend what an appropriate number of frozen eggs will be for your specific circumstances. 

Sperm Freezing (Sperm Cryopreservation)

Sperm freezing is a simple, non-invasive way to store sperm for future use. To collect sperm, an individual is usually shown to a private room or can provide a sample from home. The semen is collected in a special container via masturbation. Because medical and/or gender affirming (including hormones) treatment affects sperm production, it is important to begin collection as soon as possible, optimally before treatment begins. Since sperm production can be affected by many factors, multiple samples may be needed to increase the chances of future pregnancy. If a masturbatory sample cannot be collected, there are other options for sperm retrieval that can be discussed with a reproductive urologist, such as electroejaculation or surgical sperm retrieval (mTESE). 
 
Once collected, the sperm is mixed with a special liquid that protects it during freezing and thawing. This is a helpful option for people undergoing medical treatments that could affect fertility or those planning for future family-building. 

 

Embryo Freezing

Embryo freezing is a common way to preserve fertility. It involves a process called in vitro fertilization (IVF). First, hormone treatments stimulate the ovaries to produce multiple eggs. Once they are ready, the eggs are collected during a laparoscopic surgical procedure. 
 
If an individual chooses embryo freezing, sperm must be used to fertilize the eggs before freezing. The fertilized eggs, called embryos, are then frozen for future use. Some people choose to test their embryos for genetic conditions before freezing them. 
 
Not everyone is a good candidate for this process, so it’s important to talk to a doctor. The procedure takes about two to three weeks, and individuals undergoing cancer treatment may not have time to wait. In some cases, the hormone medications used in IVF can also increase estrogen levels, which may not be safe for someone with certain types of cancer. 
 
Embryo freezing offers the best chance of pregnancy for people undergoing cancer treatments. It has a higher success rate than freezing eggs or ovarian tissue. If embryos are not used, they can be donated to individuals or couples who cannot conceive on their own. 

Ovarian Tissue Preservation

This method involves freezing small pieces of ovarian tissue that contain eggs. Doctors remove tissue from an ovary and freeze it. Later, when the individual is ready, the tissue can be placed back into the body. There is limited information about how well this option works in transgender and gender-diverse patients. Fertility hormone treatments may be needed to help the tissue produce eggs. 
 
This procedure has some risks. It requires surgery to remove and later replace the tissue, which may need to be done multiple times. It is not recommended for people with ovarian cancer or cancers that can spread to the ovaries because reimplanting the tissue could also reintroduce cancer cells. The long-term success of this method is still being studied. 

Testicular Tissue Preservation

This method is used when sperm production is very low or for young patients who haven’t yet started producing sperm. In some cases, doctors remove and freeze small samples of testicular tissue. Later, scientists examine the tissue to find and develop sperm cells. 
 
This procedure is still experimental, and researchers are studying its effectiveness. If sperm is successfully retrieved, a special process called intracytoplasmic sperm injection (ICSI) may be needed to help fertilize an egg.