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infertility clinic Mississauga, Brampton, Bolton, Milton
 
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reproductive technology Fertility Preservation
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Treatments - Fertility Preservation
Fertility preservation is designed to guard against the impact of cancer treatment and, age (more in case of females) on egg and sperm production and their reproductive potential. Fertility preservation can also be offered in certain professions where unforeseen circumstances that can lead to gonadal (ovarian or testicular) damage or injury are more prevalent.


When to consider fertility preservation
- If you think you want to have children, but have a medical condition or social circumstances that requires that you delay pregnancy for a significant amount of time
- If you are about to undergo treatment, such as radiation or chemotherapy, that can cause infertility
- If you don’t want children now, but hope to defer child-bearing to sometime in the distant future.


Effect of Age on Fertility
Women’s Fertility declines with age since the ovary does not produce new eggs after birth compared to the testicles. Women have large but limited supply of follicles (ovarian reserve) that will finish one day and that is translated to menopause. The ovarian reserve decline both in quantity and quality as females get older. Postponing fertility is one of the leading causes of the sharp increase in female infertility.

Social egg freezing, i.e. storing mature eggs at a younger age when fertility had to be delayed for social reasons, has emerged as a viable back up option for those women. We are the first fertility clinic in Canada which offered such service for non cancer patients back in 2007.

Social egg freezing is not meant to encourage women to delay their child bearing age. Having a child later in life has its own risks which are related to pregnancy and potential complications.

Male aging also affect sperm production, sperm motility, sperm DNA fragmentation and subsequently lead to fertility decline as well. However with ART methods like IUI and ICSI, older males can restore their fertility if help is needed.


Effect of Cancer Treatment on Fertility
Certain cancer treatments can harm your fertility or cause sterility. The effects, which might be temporary or permanent, can occur immediately or at some point after treatment. The likelihood that cancer treatment will harm your fertility depends on several factors, including the type of cancer, cancer treatment and your age at the time of treatment.

Male fertility can be harmed by the surgical removal of the testicles or by chemotherapy or radiation that damages sperm quantity, quality or DNA.

Female fertility can be compromised by cancer treatments that involve the surgical removal of the uterus or ovaries. Cancer treatment can also affect eggs, hormone levels, or the functioning of the ovaries, uterus or cervix. The risk of developing premature menopause after certain cancer treatments increases as you age. Older women are also more susceptible to permanent ovarian damage.

The effects of chemotherapy and radiation therapy also depend on the drug or size and location of the radiation field. The most severe damage is caused when radiation is applied to the ovaries or testicles and by chemotherapy drugs called alkylating agents.


Methods of Fertility Preservation for Females
Women who are about to undergo cancer treatment has various options when it comes to fertility preservation:
- Embryo cryopreservation
In this procedure, eggs are harvested from your ovaries, fertilized through in vitro fertilization (IVF), frozen and stored. Typically, at the beginning of your menstrual cycle you'll begin daily injections of FSH hormone hormones to stimulate your ovaries to increase the likelihood that multiple eggs will mature and can be collected during a cycle. Mature eggs are removed, combined with sperm — provided by a partner or sperm donor — and frozen. This method has the highest chance of success for women. Timing ovarian stimulation can delay the start of cancer treatment by two to four weeks, but research suggests that random ovarian stimulation can be successful.
- Egg freezing (oocyte cryopreservation)
Similar to embryo cryopreservation, you'll get injections of a medication to stimulate your ovaries and have your eggs harvested. Then your unfertilized eggs are frozen. Two to four weeks are required to complete the process.
- Ovarian transposition (oophoropexy)
It is done laparoscopically to move the ovaries out of the danger area. It is recommended if you're having radiation applied to your pelvis and no chemotherapy — your ovaries are surgically repositioned just before radiation therapy so they're as far away as possible from the planned radiation field. However, due to scatter radiation, the procedure doesn't always protect the ovaries. After treatment, you might need to have your ovaries repositioned again or use IVF to conceive.
Other methods of fertility preservation for women still being researched include ovarian tissue cryopreservation — in which ovarian tissue is surgically removed, frozen and later reimplanted. Ovarian suppression before cancer therapy, in which hormonal therapies (depot lupron), can be used to suppress ovarian function and protect eggs during cancer treatment.


Sperm Cryopreservation for Men to Preserve Fertility before Cancer Treatment and for High Risk Professions
Men can also take steps to preserve their fertility before undergoing cancer treatment or in high risk professions.
Sperm cryopreservation
- Before you begin cancer treatment, you'll provide semen samples through masturbation or another method, such as testicular/epididymal sperm extraction via a needle. Samples are frozen and can be stored for years. Depending on the amount of sperm available, samples might be used with intrauterine insemination, where the sperm is thawed and placed in a woman's uterus or with in vitro fertilization in case of testicular or epididymal sperm.
- Screening blood work for infectious diseases like hepatitis and HIV will be done preparing for the sperm cryopreservation.

 
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