Certain types of cancer surgery may result in the removal of organs required for conception, and certain therapies may alter hormone levels or harm a female’s eggs. These side effects cause some females to lose their fertility during treatment, which might be temporary or permanent. Some women may want to take precautions to preserve their fertility in order to have children after therapy. Call and book your appointment with Dr. Kaushiki who is the best IVF doctor in Gurgaon.
Possible natural pregnancy
Females that were fertile prior to therapy may recover naturally following treatment. It may be capable of maintaining or restoring regular hormonal cycles. and develop mature eggs that can be fertilised and placed in the uterus to form a foetus The medical staff may advise waiting anything from 6 months to 2 years before attempting to conceive. Waiting 6 months may lower the chance of birth abnormalities caused by damaged eggs from chemotherapy or other therapies. The 2-year term is mainly predicated on the notion that the risk of cancer recurrence is usually highest in the first two years after therapy. The duration is determined on the type of cancer and the treatment utilised.
Women who have had chemo or radiation to the pelvic, on the other hand, are at risk for rapid, early menopause, even after they resume menstrual cycles. Menopause may begin 5 to 20 years earlier than anticipated. As a result, women should consult their doctors about how long they should wait to try to conceive and why. It is preferable to have this talk before proceeding with a pregnancy plan.
Cryopreservation, or freezing embryos or eggs, is recommended by experts to assist preserve fertility in certain cancer-stricken females. It is critical to locate a fertility expert and centre with competence in these procedures.
The procedure for collecting eggs for embryos and preserving eggs is the same. However, the timing may differ. Depending on where a woman is in her menstrual cycle, collecting eggs for embryo cryopreservation can take several days or weeks. When it is safe to do so, injectable hormone medicines are administered to females. The time of the menstrual cycle is not as critical for egg cryopreservation. To collect the eggs, a catheter is inserted via the top part of the vagina and into the ovary in both procedures.
If you have frozen eggs, embryos, or ovarian tissue, it is critical that you keep in touch with the cryopreservation facility to ensure that any yearly storage fees are paid and your address is up to date.
Freezing of embryos
Embryo freezing, also known as embryo cryopreservation, is an effective method of preserving female fertility. Mature eggs are extracted from the female and placed in a sterile lab dish with thousands of sperm. The objective is for one of the sperm to fertilise the egg. This is known as in vitro fertilisation (IVF). In vitro intracytoplasmic sperm injection (IVF-ICSI) is inserting a single sperm directly into an egg to fertilise it. The lab dish is observed in both IVF and IVF-ICSI, and if the egg is fertilised, the embryo can be frozen. After therapy is completed and the woman is ready to try for a pregnancy, the embryo is frozen and placed back into the female’s uterus in an attempt to establish a pregnancy.
The age and menopause state of a woman play a significant effect in her odds of conception, with a younger age at the time of egg retrieval resulting in a larger potential for pregnancy. The quality of the embryos is also important. Some may perish during the thawing process. Some may fail to implant properly in the uterus.
Freezing of eggs (oocytes)
Although egg freezing (or oocyte cryopreservation) has not been used as long as embryo freezing, it is an efficient approach to help women preserve fertility (described above). This may be an option for women who do not have a partner, do not want to use donor sperm to create a fertilised embryo, or have a religious objection to freezing a created embryo.
Before being fertilised with sperm, mature eggs are removed from the female and frozen. This procedure is also known as egg banking. When the lady is ready, the eggs can be frozen, fertilised with sperm from a partner or donor, and put in her uterus to try to achieve pregnancy.
Freezing of ovarian tissue
This process is still in its early stages. Laparoscopy is used to remove all or part of one ovary (a minor surgery where a thin, flexible tube is passed through a small cut near the navel to reach and look into the pelvis). Typically, ovarian tissue is sliced into thin pieces, frozen, and kept. Following cancer therapy, frozen ovarian tissue can be thawed and implanted in the pelvis (transplanted). Once the transplanted tissue begins to function normally, the eggs can be retrieved and fertilised in the lab.
Ovarian tissue removal normally does not necessitate a hospital stay. It is possible to do it before or after puberty.
Transposition of the ovaries
Ovarian transposition is the movement of the ovaries away from the radiation treatment target zone. It’s a common option for young ladies or girls who are getting pelvic radiotherapy. It can be used prior to or after puberty.
This treatment is frequently performed as outpatient surgery and does not necessitate hospitalisation (unless it is being done as part of a larger operation). Typically, surgeons would relocate the ovaries above and to the side of the central pelvic area. Because they tend to slip back into their natural position over time, it’s usually better to conduct the operation right before starting radiation therapy.
This procedure’s success rates vary. Ovaries are not always protected due to radiation scatter, and patients should be advised that this technique is not always successful.
It is difficult to estimate the price of ovarian transposition because this treatment is occasionally performed concurrently with another surgery that is reimbursed by insurance.
Fertility preservation surgery
In the case of early-stage cervical cancer, the surgeon may be able to remove the cervix (trachelectomy) without having to remove the entire uterus or ovaries. In the case of early-stage ovarian cancer that only affects one ovary, the surgeon may be able to remove the diseased ovary but not the other. Both of these procedures can aid in the preservation of fertility. For more information, please see the photos below.
Suppression of the ovaries
Gonadotropin-releasing hormone (GnRH) agonists are long-acting hormone medications that can be used to induce menopause in a woman for a limited period of time. This is known as ovarian suppression. The purpose of this treatment is to prevent the ovaries from being damaged during cancer treatment by shutting them down. The expectation is that by lowering ovarian activity during therapy, the amount of damaged eggs will be reduced, and women will be able to resume normal menstrual cycles after treatment. However, research on the effects of this medication as a method of preserving fertility is limited. Experts advise against utilising ovarian suppression in place of cryopreservation or other proven fertility preservation procedures.
Progesterone therapy for uterine cancer in its early stages
Endometrial hyperplasia (pre-cancerous alterations in the cells that line the uterus) or an early-stage, slow-growing malignancy of the uterine lining can occur in younger women (adenocarcinoma). The standard treatment would be a hysterectomy (surgery to remove the uterus). Women with stage 1 endometrial cancer who still desire to conceive a child may be able to be treated with the hormone progesterone, either through an intrauterine device (IUD) or as a pill. After giving birth, many women will have their uterus, fallopian tubes, and both ovaries removed. Because they are at greater risk of ovarian cancer, many physicians think that young women with uterine cancer should not freeze ovarian tissue and then reintroduce it into their bodies.Call and book your appointment with Dr. Kaushiki who is the best IVF doctor in Gurgaon.