Options for Females

Females can take certain steps and precautions to preserve fertility before, during and after treatment. 

Options to Preserve Fertility Before Treatment

• Embryo freezing - This involves about 10 days of hormone injections to stimulate the ovaries followed by retrieval of mature eggs performed under anesthesia. The eggs are fertilized in the laboratory with sperm from a partner or donor to create embryos (IVF or in vitro fertilization). The embryos are then frozen and stored for possible future use. Embryo freezing is the option with the highest likelihood of success for females. The process typically takes at least two to three weeks.
• Egg freezing - This involves about 10 days of hormone injections to stimulate the ovaries, followed by retrieval of mature eggs performed under anesthesia. The eggs are then frozen and stored for possible future use without being fertilized. The process typically takes at least two to three weeks.
• Ovarian tissue freezing - Girls who have not yet gone through puberty have no mature eggs, and women who must start treatment quickly do not have the two to three weeks required to undergo egg or embryo freezing. They may be able to undergo a procedure in which part of the ovary (or the entire ovary) is removed and frozen for possible future use. Only a small number of pregnancies have resulted from re-implanting tissue, and this may not be safe for patients with certain types of cancer. Further research is needed.
• Ovarian transposition - If the ovaries will be in the radiation treatment field, patients may undergo this minor surgical procedure in which a doctor moves the ovaries outside of the radiation field to minimize exposure and radiation damage.
• Gonadotropin-releasing hormones (GnRHs) - This is a medication used during chemotherapy to suppress ovarian function and possibly protect the eggs from damage. Further research is needed.
   

Options For Having a Family After Treatment

• Use of your frozen eggs or embryos - If you froze eggs, they will first be fertilized in the laboratory with your partner’s sperm to create embryos. The embryos are transferred to your uterus.
• In Vitro Fertilization (IVF) - If you have a low ovarian reserve (low egg count) you may want to consider undergoing an IVF cycle to remove mature eggs so they can be fertilized in the laboratory with your partner’s sperm. The embryos created are transferred to your uterus.
• Donor eggs - Eggs donated by another woman who undergoes an IVF cycle can be fertilized in the laboratory with your partner’s sperm. The embryos created are transferred to your uterus.
• Donor embryos - Embryos are generally donated by couples who have undergone IVF for infertility. They now have families and choose to donate their remaining embryos rather that discard them. The embryos are transferred to your uterus.
• Surrogacy - If you are unable to carry a child, you can arrange for another woman to carry for you. She is called a gestational carrier. Embryos created by your eggs or donor eggs are transferred to her uterus. 

Related Links

• Download or order The Leukemia & Lymphoma Society’s free fact sheet, Fertility Facts.