Infertility among women is on the rise, particularly in urban India. Besides, women who have survived cancer, experience infertility or fail to carry a pregnancy to term as a side effect of chemotherapy.
In India, where the population is relatively young compared to the Western world, these health concerns surrounding infertility after chemotherapy, have created a need for effective methods of fertility preservation. Certain types of cancer surgery can result in removal of organs needed for a pregnancy, and certain treatments might change hormone levels or cause damage to a female’s eggs. These effects result in some females losing their fertility during treatment that can be either temporary or permanent. Modern medicine has provided several options for fertility preservation, including embryo preservation and egg freezing.
Embryo preservation is the most successful method of fertility preservation, but it requires a married couple, with eggs harvested from the female partner and sperm donated by the male partner. These gametes are combined in a laboratory and cryopreserved for later use. After the completion of cancer treatment and a period of follow-up, the healthy embryos can be implanted into the uterus. This method has the highest rate of successful pregnancy post-treatment, but it is also the most costly and logistically challenging.
Egg freezing is another option that can be utilised by unmarried women. Mature eggs are removed from the female and frozen before being fertilised with sperm. This process might also be called egg banking. When the woman is ready to become pregnant, the eggs can then be thawed, fertilised by a partner’s or donor’s sperm, and implanted in her uterus to try to achieve pregnancy.
The eggs can be preserved for long periods of time and used for pregnancy when the woman is ready. The advantage of this method is that it does not require a male partner, but it also requires the patient to wait for the eggs to be harvested before starting treatment, putting them at risk of disease progression. With modern techniques, the ovaries can be stimulated at almost any time of the menstrual cycle, reducing the wait time. Theoretical concerns surrounding cancer progression with ovarian stimulation in certain types of hormone-sensitive breast cancers have also been addressed with the use of anti-cancer drugs for ovarian stimulation.
Another method of fertility preservation is ovarian function suppression (OFS) with drugs before the initiation of cancer treatment. OFS temporarily suppresses the ovaries and prevents damage caused by chemotherapy drugs, making it relatively cheap and less time-consuming. However, it is not as successful as embryo preservation.
Modern medicine has made it possible for women to have successful motherhood after cancer treatment. There are several options to choose from, depending on affordability and disease stage and type. However, like all medical treatments, fertility preservation also comes with associated costs and minimal risks.
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