5 - Assisted reproductive technology for preserving fertility in women with cancer

Summary

Assisted reproductive techniques (ART) that can help women under the age of 40 years are: in vitro fertilisation (IVF) with embryo cryopreservation; ovarian stimulation with mature oocyte cryopreservation; and ovarian tissue banking. Cryopreservation of embryos, oocytes or ovarian tissue is indicated where treatment for cancer is likely to lead to significant damage to the ovaries and reduction in subsequent fertility. Ovarian tissue cryopreservation, which shows great promise for female fertility preservation, is not an established technique and should be considered to be investigational. Embryo, sperm and oocyte storage is licensed by the Human Fertilisation and Embryology Authority (HFEA), which requires infection screening of the gamete and embryo providers. This chapter discusses the cryopreservation methods for each method of fertility preservation. Orthotopic transplantation can be performed laparoscopically or as an open procedure. Consent for all these procedures should be fully informed and the women should have access to specialist counseling.