Fertility Preservation 10 2011

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					Fertility Preservation 2011
    Jennifer Kirkwood BSN, RN
 Briefly discuss how cancer & the treatment of can
  affect fertility
 Have an understanding of options available for fertility
 Achieve an understanding of the referral process to a
  Reproductive Endocrinologist for fertility preservation

               As part of education and informed consent before cancer
            therapy, oncologists should address the possibility of infertility
              with patients treated during their reproductive years and be
             prepared to discuss possible fertility preservation options or
                refer appropriate and interested patients to reproductive
               specialists. Clinician judgment should be employed in the
                timing of raising this issue, but discussion at the earliest
                           possible opportunity is encouraged.
 The (REI) specialist in reproductive endocrinology and
  infertility will work with YOUR time frame
 The REI can counsel the patient on fertility options
 Each patient needs an INDIVIDUALIZED consultation to
  determine the best technology available in their unique
  circumstances and according to their informed choice
 The sooner the REI speaks with the patient the more options
  there may be available
      Timing is key
   Consult with Reproductive endocrinologist
    ASAP to discuss options
   Procedures begin with start of menses
   Stay on birth control pills
   Do NOT start lupron
   Can take 2- 6 weeks
Fertility Preservation Options for Men and Women
 OPTION                                                OPTION TYPE

 Sperm banking                                         Valid option at TFC-
 Testicular tissue freezing ( pre- pubertal)           Experimental
 Egg freezing                                          Valid option with IRB
 Ovarian tissue freezing                               Experimental
 Embryo freezing                                       Valid option at TFC
 GnRH analog treatments                                Valid option at TFC
 Donor sperm, eggs or embryos                          Valid option at TFC
 Adoption (domestic, international, public, private)   Valid option
 Gestational Carrier                                   Valid option at TFC

 Prevention of ovarian failure
   Gonadal suppression, ovarian transposition
 Cryopreservation
   Oocytes, embryos, ovarian tissue, sperm, testicular
 Transplantation of ovarian tissue
 Conservative surgical approaches
 Donor oocytes, gestational surrogacy, adoption
In Vitro Fertilization
 Embryos frozen and utilized for a future pregnancy

 Pregnancy success in <38 is 45%

 The Fertility Center Donor Embryo Program established
Oocyte Cryopreservation

  The first human live birth from cryopreserved oocytes was reported by Chen et al.
   in 1986
                                                       Chen, et al. Lancet 1:884;1986
  Slow freezing methods for oocyte cryopreservation are most commonly utilized,
   however, vitrification is a newly emerging cryopreservation technology

  The first live birth from vitrified oocytes was reported in 1999:
                                                            Cha et al. Fertil Steril 72 (suppl 1):S2; 1999

  Oocyte (egg) Vitrification or rapid freezing allows women to freeze their eggs
   when they are young for potential future use

  Potential benefit for patients at early cancer diagnosis to preserve fertility
   Fertility Preservation for the Male

•Cryopreservation of ejaculated sperm is
well established
•Testicular tissue cryopreservation (Experimental
for the pre-pubertal boys)
•Should see Reproductive Endocrinologist office
for cryopreservation
•Patients sent to our office need an order from
their physician
•Sperm is cryopreserved at our office then sent
to Reprotech for storage
•Financial aid is available for qualifying patients
through Reprotech
• Patients should be seen within 24-48 hours for consult

• Insurance/Financial support

• Many clinics offer fertility preservation services at a
 reduced rate or bunched cost
• Collaboration with patient advocacy groups for
 additional educational, financial, emotional support
 Nationwide Referral Line for Patients and Providers
    866-708-FERT (3378)
 For patients:
    www.myoncofertility.org
    www.fertilehope.org
 For researchers and physicians
    www.oncofertility.northwestern.edu
    www.livestrong.org
    www.asco.org
    www.asrm.org
                 The Fertility Center
 Dr. Dodds, Dr. Young & Dr. Leach
 616-988-BABY (2229)
 www.fertilitycentermi.com
 Grand Rapids, Kalamazoo, Lansing
 Cryopreservation of sperm, embryos, donor
  sperm, donor eggs, donor embryo

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