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Advances in the treatment of cancer have led to impressive improvements in the long-term prognosis of female patients. Unfortunately, a major complication of these increasingly effective cancer therapies is reproductive failure resulting in the woman's temporary and even permanent infertility or sterility. We offer a range of technologies to help female cancer patients preserve their fertility. Reproductive Sciences Center has provided comprehensive fertility services to oncology patients for over 10 years.
Combination chemotherapy regimens and radiotherapy commonly produce menstrual irregularities as well as infertility. Total-body irradiation used in the preparative regimens for bone marrow transplantation is damaging to endocrine and ovarian function. For young cancer patients wishing to preserve fertility there are now several options available including ovarian tissue cryopreservation and transplantation, egg freezing and embryo freezing. When choosing a cryopreservation technique, women must consult their oncologist and a reproductive endocrinologist to evaluate their individual medical and personal needs.
Who are potential candidates for embryo freezing?
Women who have a partner, or wish to employ the use of donor sperm, are able to undergo in vitro fertilization before chemo- or radiotherapy and have their embryos frozen for a later embryo transfer.
What is the success rate of embryo freezing?
Although isolated pregnancies from egg freezing have been reported for many years, it is only recently that egg freezing can be performed with reproducible success resulting in reasonable survival rates (50-70%), fertilization rates (50-60%) and pregnancy rates approaching those obtained with fresh eggs. Embryo freezing is a well established procedure in most IVF laboratories, and generally results in reasonable success rates. The national average live birth rates for women under 38 years of age is 21% (ASRM/SART Report, 2000). For Reproductive Sciences Center's most recent frozen embryo success rates, see latest IVF success rates.
What are the disadvantages of embryo freezing?
This approach is limited by the time required to perform the IVF procedures. There may not be enough time for a complete IVF cycle before cancer treatment must be initiated. As with all advanced fertility treatment options, there is no guarantee that you will respond appropriately to the ovulation induction medications and produce a reasonable number of fertilized eggs and healthy embryos for freezing. In addition, ovulation induction may not be advised for certain cancer patients.
Who are potential candidates for egg freezing?
All women planning to undergo cancer therapy that can result in irreversible ovarian failure. In particular, women who do not have a partner and reject the use of donor sperm, or, do not wish to have embryos frozen for ethical or religious reasons. As with embryo freezing, egg freezing necessitates undergoing controlled ovarian hyperstimulation (to induce multiple follicular development), prior to chemo- or radiotherapy and is therefore not advised for certain medical conditions.
Are there potential risks associated with freezing eggs?
Yes, earlier concerns regarding possible detrimental effects of freezing on the genetic constitution of eggs have been largely alleviated as normal healthy babies have been born. Nevertheless, despite the major improvements with this approach, egg freezing should still be considered experimental as more data is needed to optimize the technique and determine potential risks to offspring.
Who are potential candidates for ovarian tissue cryopreservation?
Patients for whom lengthy hormonal stimulation and egg or embryo cryopreservation is unsuitable. In particular, children and very young women, patients undergoing bone marrow transplantation (where intensive therapy results in a very high rate of ovarian failure), and patients undergoing oophorectomy for endometriosis, breast cancer or benign ovarian tumors.
How successful is ovarian tissue cryopreservation?
Although still considered experimental, cryopreservation of tissue from the outer region (cortex) of the ovary, which contains numerous primordial follicles and immature eggs, has evolved into a promising development for fertility protection. To date, successful ovarian tissue cryopreservation and transplantation is limited to various animal species. At this time, no pregnancies have resulted from human cryopreserved ovarian tissue, although, there is a recent report of follicle growth after transplant of frozen-thawed ovarian tissue in a patient with benign ovarian disease. Research studies are being conducted to determine whether transplantation of cryopreserved ovarian tissue to the original site or a different site is preferable.
What are the safety concerns with ovarian transplantation?
The risk of reintroducing cancer cells depends on the disease type (high risk are leukemia and neuroblastoma, breast cancer carries a low to intermediate risk), activity, stage and mass of malignant cells transferred.At the time of ovarian removal, samples are taken and screened for the presence of cancer cells in the ovary. There is a need to develop improved screening methods that can detect minimal residual disease in ovarian tissue.
More information for cancer patients is also available at FerileHope.
Our fertility specialists at The Reproductive Sciences Center, or RSC, are conveniently located in La Jolla California in San Diego County. We have worked hard to create and maintain our reputation as the first-rate San Diego fertility clinic and sciences center. RSC has become synonymous with comprehensive and successful female and male infertility treatment, egg donor programs and surrogacy options, in vitro fertilization, ICSI and more.
While we have provided services to hundreds of patients throughout the Temecula, Murrieta, La Jolla, Riverside,San Bernardino and Encinitas areas, we also help many people from across the United States, Europe, Australia , Asia, Africa and the Americas who make us their final destination for treatment with infertility in San Diego. We lead the area as one of the leading fertility centers in the world.
Our fertility center has long been established as having one of the highest fertility success rates in the world, and with more than 75 years of combined medical training, experience and ongoing continuing education, our fertility specialists set the bar for the industry. Our medical director and leading fertility doctor is one of the most well-respected experts in the world.
Successful fertility treatment in San Diego is only possible with the best fertility specialists and staff in OrangeCounty. We have been providing unsurpassed treatment for infertility in San Diego, including IVF (In Vitro Fertilization) and other San Diego fertility services in La Jolla for more than a decade.
Some of our successful options for fertility treatment in San Diego include natural fertility treatment, advanced fertility treatment, IUI (Intrauterine Insemination), San Diego In Vitro Fertilization (IVF), ICSI for severe male infertility, genetic testing, embryo donation, blastocyst transfers, assisted hatching, and more. We are the top professionals of fertility options for women with cancer and fertility options for men with cancer in San Diego as well.
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