Understanding Fertility Preservation

"Preserving your fertility involves freezing your eggs, sperm, embryos or reproductive tissue so that you can hopefully have a biological family in the future" ("Fertility preservation"). This process can be done for either medical or social reasons.

Medical reasons

Some people diagnosed with cancer often undergo aggressive treatments that can damage gametes (collective name for eggs and sperm). In men, systemic chemotherapy and radiotherapy for some cancers such as testicular cancer can lead to testicular failure. In women, the eggs are known to be highly susceptible to the effects of chemotherapy and more so to pelvic radiotherapy. Women may also be advised to wait for a certain period before getting pregnant after cancer therapy. As fertility declines with age in women, it is highly recommended that they preserve their fertility through egg freezing before starting treatment. Frozen gametes can then be used in future to conceive a biological child through artificial insemination treatment, IVF or ICSI. Those in a steady relationship at the time of medical treatment may prefer to fertilise the eggs with sperm and freeze the embryos instead (“Fertility Preservation (for Patients Diagnosed With Cancer or Conditions That Compromise Fertility").

There are other non-cancerous conditions that can cause premature infertility such as premature ovarian insufficiency. Other conditions may require surgery or medical treatment that affects the reproductive system such as renal dialysis which can cause low sperm count in men ("Sexual Relationship in Kidney Failure Having Children").

Social reasons

Fertility in women is expected to decline from their mid thirties ("At what age does fertility begin to decrease?" ). As fertility declines, it becomes harder to conceive naturally and some women may end up having to conceive through IVF with the use of donated eggs due to poor egg quality. Poor egg quality is attributed to chromosomal birth abnormalities such as Downs syndrome.

In today's world, most women prefer to establish their careers first before settling down to start families. For some the delay is simple due to the fact that they have not found a suitable partner. Whatever the reason maybe, social egg freezing has become more popular in recent years to secure the chance of having a biological child in future. However, not a lot women are aware of this procedure or have the financial means to do it.

Oocyte cryopreservation (egg freezing) procedure

A woman who has decided to freeze their eggs will have to go through a medical process of ovarian stimulation and egg retrieval. The retrieved eggs will then be cryopreserved by a process of vitrification. One treatment cycle takes up to two to three weeks. The process will involve self injecting with ovarian stimulation injections to increase the number of eggs produced by the ovaries. This will be followed by an egg retrieval process in which the patient will be sedated for the procedure. It is important that women understand this process so as to be mentally prepared for this uncomfortable process.. The age at which it is best for women to freeze their eggs varies as stated below.

• Technically you can freeze your eggs at any age before menopause. 

• Eggs retrieved in your 20s and early 30s usually result in better outcomes than those in your late 30s and 40s.  

• This is because over time both the quality and quantity of your eggs decline. 

• Some clinics may impose an age limit for treatment based on ethical and medical reasons ("What Age Should You Freeze Your Eggs?").

For medical purposes, freezing of gametes will be facilitated by the hospital that the patient is receiving treatment at. This will usually be NHS funded in the UK unless the patient is not eligible for NHS funding. For social egg freezing, an individual will have to choose a clinic that supports egg freezing and cover the cost of the whole procedure for themselves. According to the Human Fertility & Embryology Authority (HFEA) the estimated costs of the procedure in 2025 are as follows:

"The average cost of having your eggs collected and frozen is £3,350, with medication being an added £500-£1,500. Storage costs are extra and tend to be between £125 and £350 per year. Make sure you get a full costed treatment plan from your clinic so you're not caught out by unexpected 'extras'.

Thawing eggs and transferring them to the womb costs an average of £2,500. So, the whole process for egg freezing and thawing costs an average of £7,000-£8,000" ("Egg freezing")

Frozen sperm, eggs and embryos can now be in storage for 55 years in the UK but a person must sign consent every 10 years to allow the clinic to continue the storage.

Life style modifications to preserve fertility

Medical fertility preservation is too expensive for most people to afford therefore fertility education needs to be taught in schools and universities so that women understand from an early age how to stay fertility healthy. It is important to eat healthy, especially foods high in antioxidants to maintain ovarian health. Women must avoid excessive intake of alcohol and smoking. Smoking is known to cause egg quality decline, follicular depletion, hormonal disruption and reduced blood flow to the ovaries. It can also also cause blockage of the fallopian tubes leading to ectopic pregnancies ("How does smoking tobacco affect fertility"). Regular exercise to maintain a healthy BMI and increase blood flow to the ovaries is recommended.

An important aspect of fertility health is to maintain a healthy menstrual period pattern. Women need to be educated about the signs of an abnormal period such as excessive bleeding and pain that needs extra strong painkillers. It is advisable to seek the opinion of a doctor as abnormal periods can be a sign of conditions such as endometriosis that can lead to infertility. Above all keep the conversations going and enlighten others, it may make the journey to parenthood later in life much easier for them. And for those women who lean on their spiritual faith, don't shy away from including your fertility in your prayers.

Works Cited

At What Age Does Fertility Begin to Decrease? » British Fertility Society. www.britishfertilitysociety.org.uk/fei/at-what-age-does-fertility-begin-to-decrease. Accessed 27 January 2025.

Egg Freezing | HFEA. www.hfea.gov.uk/treatments/fertility-preservation/egg-freezing. Accessed 27 January 2025.

Fertility Preservation | HFEA. www.hfea.gov.uk/treatments/fertility-preservation. Accessed 27 January 2025.

“Fertility Preservation (for Patients Diagnosed With Cancer or Conditions That Compromise Fertility) - Saint Mary'S Hospital.” Saint Mary’s Hospital, 9 Jan. 2025, mft.nhs.uk/saint-marys/services/gynaecology/reproductive-medicine/fertility-preservation-for-patients-diagnosed-with-cancer. Accessed 27 January 2025.

Lukaszewski, Tomasz. “How Does Smoking Tobacco Damage Fertility?” IVI UK, 22 Aug. 2024, www.ivi.uk/blog/smoking-tobacco-damage-fertility/#:~:text=For%20women%2C%20smoking%20disrupts%20normal%20ovarian%20function%20and,tobacco%20also%20damage%20the%20eggs%20in%20the%20ovaries. Accessed 27 January 2025.

“Sexual Relationship in Kidney Failure Having Children.” National Kidney Federation, www.kidney.org.uk/sexual-relationship-in-kidney-failure-having-children. Accessed 27 January 2025.

“What Age Should You Freeze Your Eggs? - Hertility Health.” Hertility, hertilityhealth.com/blog/what-age-to-freeze-eggs. Accessed 27 January 2025.