Fertility Preservation & Assisted Reproduction Techniques
The introduction of in vitro fertilization (IVF) as an exciting method to treat infertility and the birth of Louise Brown in England more than 3 decades ago set the stage for thousands of infertile couples who benefited from this new technology. In addition, the availability of several hormones for ovarian stimulation and follicular development, new techniques for egg retrieval and embryo transfer utilizing sonography, new laboratory methods for embryo culture, improved egg, sperm, and embryo cryopreservation, Transdermal surgical sperm retrieval, Intracytoplasmic sperm injection (ICSI) and preimplantation genetic screening and diagnosis (PGS & PGD) have resulted in a very significant and encouraging increase in the number of pregnancies resulting from IVF.
Couples seeking treatment for infertility, however, are not the only beneficiaries of these new assisted reproductive techniques. For instance, during last several years fertility preservation has become a very prominent area of interest in both reproductive medicine and oncology. Today fertility preservation is no longer a theoretical concept but an essential clinical discipline in medicine and mostly applies to two groups of patients;
- Patients diagnosed with different types of cancers who are about to embark on chemotherapy, radiation therapy or extirpative surgery. Cancer treatments with Chemotherapy, radiation therapy, or both can significantly damage gonads (ovaries or testes) and patient’s fertility potential resulting in infertility. For these patients fertility preservation is the only option to conserve their reproductive potential. The early diagnosis of and available new treatments for most if not all different types of cancer have greatly lowered the death rate and significantly improved the prognosis for young reproductive age (age 20-39 years old) patients. As a result, many patients surviving cancer who are younger than age 40 expect maintenance of their fertility and reproductive potential following cancer treatment. Assisted Reproductive services including Oocyte Retrieval (egg harvest) and egg (or embryo) cryopreservation in women or sperm cryopreservation in men prior to cancer treatment would allow these patients to conserve their fertility potential and become pregnant after completion of their cancer treatment.
- Individuals who have deferred pregnancy for a variety of reasons such as single women who choose to have their eggs preserved for fertility assurance (social fertility preservation). Several studies have shown that the main reasons for women postponing parenthood to a later stage in life are not having met a suitable partner or the Mr. Right and the increased desire to achieve higher educational, financial or career goals. The lack of awareness of the age related decline in fertility in women are major contributing factors to the increased incidence of childlessness at later stages of life. As a result, there is increasing number of woman choosing to become first time mothers after the age of 35. The recent advances in assisted reproductive services and utilization of better Oocyte cryopreservation (egg freezing) techniques including Oocyte Vitrifications has allowed women to increase their chances of motherhood at a later age by giving them the opportunity to save at least a small number of their eggs at a younger age to be utilized at a later time if needed. The success rates with frozen eggs in achieving a live birth depends on the age at which the eggs are cryopreserved (frozen) and the experience of the clinic involved. A yield of 10-12 mature Oocytes is expected to result in 50% probability of a live birth. The age threshold with the highest capability of discriminating success from failure for live birth outcome is 36. It is estimated that the probability of live birth for a 30-year-old woman who has six eggs to thaw is 24% after rapid freezing (Vitrification). This probability however, decreases to 18% & 14% if the age is 38 and 42 respectively.
“Helping patients build a family is my passion. I am completely invested in your treatment and will apply my full knowledge and abilities to achieve your goals.” Dr. Guerami