Cryopreservation of ovocytes for fertility preservation

Due to the increasingly effective therapies in the oncological field, there is a considerable increase in the number of patients who, now cured, want a full return of the quality of life. In this context, more and more women of childbearing age will desire a child after recovering from the neoplastic disease. Cancer therapies can affect fertility to a very variable extent depending on the age of the patient and her starting ovarian reserve, the type of drugs and dosages used, environmental factors. At diagnosis, it is always necessary to consider a fertility preservation plan that takes into account the patient's individual characteristics and does not interfere with the timely initiation of cancer treatments. In our center, the fertility preservation consultation does not have a waiting list and, if the patient is eligible, allows immediate access to the most commonly used technique for fertility preservation, i.e. oocyte cryopreservation.

Oocyte cryopreservation can be performed in adolescent and young adult patients and takes approximately 12 to 14 days total. The patient is a candidate for controlled hormonal stimulation that can be started at any stage of the cycle (random start) in order to obtain the simultaneous growth of multiple follicles. Patients with hormone-sensitive neoplasms are given drugs that maintain low estrogen levels during stimulation, making the procedure safe from an oncologic standpoint. During stimulation, ultrasound monitoring of follicle growth is performed. At the end of the stimulation, the oocyte collection is performed transvaginally, using ultrasound guidance. The procedure is performed under sedation. Recovered oocytes are analyzed by a biologist and cryopreserved by vitrification. There are no limits on the duration of oocyte storage in the biobank. Once the patient has completed the oncological treatment and the necessary follow-up, it will be possible to access an assisted reproduction program that includes thawing of the oocytes and their in vitro fertilization.