Female Fertility Preservation: What are my Options?
Cancer and Fertility (onco-fertility)
You have recently been diagnosed with cancer and you may be wondering how this will affect
your chances of becoming a parent in the future. Your health care team is here for you. They
can refer you to the Fertility Clinic at LHSC to help you understand the effects of your cancer
treatment on your fertility and improve your chances of becoming a parent. We understand the time limitations and the emotional and financial stress you may be facing. The LHSC Fertility Clinic gives priority to cancer centre referrals and can meet with you to support you in reaching your goals of building a family in the future.
What Are My Options?
There are different options for preserving your fertility and these depend on many different factors such as the type of cancer, treatment, fertility status, and timing. Some procedures are offered at the LHSC Fertility Clinic and others are not. If you are interested in an experimental procedure, the clinic can help you work with locations that do offer those procedures.
| Embryo freezing (embryo cryopreservation) | This procedure is suitable for females that have reached puberty and either have a committed partner or wish to use donor sperm. Medications will stimulate your ovaries to release eggs (oocytes). These eggs will be fertilized with sperm in a dish (in vitro) and frozen. This option has the best success rate for pregnancy. | Available in Canada | Not Covered by OHIP |
| Egg freezing (mature oocyte cryopreservation) | This procedure is suitable for females that have reached puberty and do not have a committed partner or do not wish to use donor sperm. Medications will stimulate your ovaries to release eggs (oocytes). The eggs will be frozen and stored until you are ready to use them. This option has approximately an 8-20% success rate for pregnancy. | Available in Canada | Covered by OHIP |
| Ovarian transposition | Patients that need radiation to their pelvic area can have a surgery that moves the ovaries out of the area of radiation (ovarian transposition). This means that the ovaries will receive less exposure to radiation so that they can keep working properly after your treatment. | Available in Canada | Covered by OHIP |
| Ovarian tissue freezing (ovarian tissue cryopreservation) | This procedure involves freezing sections of tissue from the ovaries. This procedure is experimental and is especially important for pre-pubertal females who cannot delay cancer treatment. No live births have been reported in females who cryopreserved tissue before puberty. | Available in Canada | Not Covered by OHIP |
| Eggs grown in a dish (In vitro maturation) | Eggs can be removed from the ovarian tissue and grown in a dish with special fluids. These eggs can be fertilized with sperm or frozen and stored in an unfertilized state. It is important to note that implantation and pregnancy rates are much lower than with standard in vitro fertilization (IVF). This is still considered an experimental procedure. | Available in Canada (Limited Areas) | Not Covered by OHIP |
| Ovarian suppression (GnRH/LHRH agonists) | This procedure is still controversial, but it is an option for patients that are unable or unwilling to freeze eggs. Monthly injections are started before chemotherapy and will continue until chemotherapy stops. This therapy is meant to suppress the ovaries so that they aren’t as impacted by chemotherapy. The goal is to protect the ovaries | Available in Canada (may be covered by some benefit plans) | Not Covered by OHIP |
Special Considerations for Patients with Hematologic (Blood) Cancers
Some fertility therapies require a delay in treatment, and some patients may be too ill to wait. In patients with blood cancer, there is a risk in freezing tissues that may contain malignant cancer cells. Lastly, blood cancers can put patients at risk for surgical complications from some fertility procedures.
What are the estimated costs?
The cost of each procedure varies widely. The Fertility Clinic will also help cancer patients to apply for low or no-cost medications from pharmaceutical companies. There may be a cost for storage of frozen material. For financial information, you can contact the financial administrator at 519-685-8500 extension. 32687
What happens after my treatment?
Your health care team will let you know when it is safe to become pregnant after treatment.
More Information
For more information, talk to your health care team. To speak with someone at The Fertility Clinic, call 519-663-2966 extension. 1 or visit www.londonfertility.ca for more information.
