On the occasion of World Cancer Day, CREA highlights the effectiveness of vitrification technique compared to classic freezing method to avoid cell damage

• Oncology treatments leave women ovarian reserve 10 years older thus reducing pregnancy chances after having overcome the disease. 

• They point out ovarian autotransplant and ovarian tissue freezing as future options in fertility preservation 

Valencia 03.02.15 Thanks to progresses in fertility preservation, nowadays a patient with cancer is not condemned to renounce to future paternity/maternity. “The occurrence of cancer does no longer involve a renounce to have descendants” This has been pointed out by CREA (Medical Centre for Assisted Reproduction Medical Centre in Valencia), pioneer in stop using the classic freezing method. Since 2005 CREA has been supporting vitrification technique as unique method to maintain the embryos at low temperaturas avoiding intracellular crystals formation and thus, cells damage that cryopreservation might provoke. 

Some of the oncology treatment’s consequences might be amenorrhea (absence of menstrual period) and reduction of woman ovarian reserve as if the woman was 10 years older, which reduce pregnancy chances once that the disease is over. In this sense, Doctor Carmen Calatayud, CREA’s co-director considers that women who are going to receive an oncology treatment must preserve their fertility before starting the chemiotherapy or radiotherapy, “as their effects on fertility might be devastating. Preservation success will mainly depend on the rapidity of action”. However, she points out that each case must be studied individually “as ovarian stimulation might not be recommended to patients presenting metastasis”.

Thanks to progress in these techniques, women suffering from cancer are offered the opportunity of achieving their dream of being mothers once the disease is over, without renouncing to a descendant from her own genetic material. Oocytes and embryos vitrification are the most effective techniques. In both cases a previous ovarian stimulation and oocytes retrieval through follicle aspiration are required. Once the oocytes are retrieved, the mature and good quality ones will be vitrified. As concerns embryos vitrification, the oocytes will be inseminated with the partner sperm or with anonymous donor sperm, according to the case. “Embryos vitrification technique has made possible an higher effectiveness due to better survival and implantation rates, that mean better pregancy rate, that mean better pregnancy rate”.

As concerns ovarian tissue cryopreservation and its posterior in vitro maturation, CREA’s co-director has stressed out that “it’s a technique with a very interesting future”. In reference to ovarian autotransplant, she has pointed out that although it is rarely used, it represents another option for these patients. It consists of transplanting the ovary to an area that is not going to receive radiotherapy, so that this doesn’t affect the ovarian reserve. (heterotopic transplant) . In cases of ovarian tissue re-implantation, not only fertility is preserved but it is also possible to recover the ovarian endocrine function.

MALE FERTILITY PRESERVATION

As concerns fertility preservation for men who are going to receive an oncology treatment, previous cryopreservation of semen will be performed. Survival rate of each frozen sample will be assessed and according to the result it will be recommended to freeze as many sample as possible before starting the treatment.

As to help early detection of testicular cancer or any other reproductive pathology in the male, among others routine as self-exploration, CREA recommends a semen analyses to men between 15 and 35. As CREA’s co-director has stressed “testicular cancer is the most frequent among youngsters between 15 and 35 and its appearance is currently increasing”. Dr. Calatayud has advised that “on occasions the only appearance sign of these diseases is an alteration in sperm production, which can only be diagnosed through semen analysis”

Society’s demand for fertility preservation has been increasing in the last few years both for medical and social reasons. In this sense, she has pointed out that currently the average age at first baby is between 30 and 34 but in a 20% of cases it is between 34 and 39. In those cases where the reason to preserve fertility is to postpone maternity voluntarily, it’s recommendable to do fertility preservation before the age of 35 in order to ensure a better ovarian quality and thus better chances in the future.