Fertility preservation options for those with breast cancer*
| Embryo banking (i.e. embryo freezing, ‘emergency’ IVF) | Egg banking (i.e. oocyte/egg freezing) | Ovarian tissue cryopreservation (i.e. ovarian tissue banking) | Other options available prior to cancer treatment† |
|---|---|---|---|
| “Harvesting eggs, IVF and freezing of embryos for later implantation.”19 | “Harvesting and freezing of unfertilised eggs.”19 | Surgical removal of one or both ovaries. The ovaries are cut into cortical strips, which are cryopreserved for future use. | (1) Choosing a chemotherapy regimen or treatment with a lowered fertility risk. (2) Ovarian suppression to protect ovaries during chemotherapy using GnRH analogues.19 (3) Gonadal shielding and transpositioning during radiation.19 20 |
| ▸ Requires hormonal stimulation to mature and harvest eggs. | ▸ Requires hormonal stimulation to mature and harvest eggs. | ▸ Does not cause significant delay in treatment. | |
| ▸ Can delay treatment up to 1 month or more.19 | ▸ Can delay treatment up to 1 month or more.19 | ▸ Requires laparoscopic surgery. | |
| ▸ Requires sperm for fertilisation.19 | ▸ Does not require sperm for fertilisation.19 | ||
| ▸ Still considered experimental.19 | ▸ Still considered experimental.19 | ||
| Success rates: | Success rates: | Two options: | |
| ▸ “Approximately 40% per transfer; varies by age and centre.” | ▸ Considerably lower than for embryo freezing, but 200+ live births have been reported.19 | (1) Follicles from stored tissue can be matured in vitro in order to facilitate fertilisation.20 Success rates: ▸ No live births. Successful animal model trials.20 (2) Ovarian tissue can be transplanted back into patient post-cancer.19 Success rates: ▸ Case reports of eight live births worldwide.21 | |
| ▸ “Thousands of babies born.”19 |
*These options are not limited to only those with breast cancer, but represent the range of current options available to women with cancer more generally. However, other cancers may have different advisable options.
†Also, there are post-cancer options available such as adoption and surrogacy with donor eggs that physicians can also discuss with patients.19 ,20
GnRH, gonadotropin-releasing hormone; IVF, in vitro fertilisation.