The Reproductive Medicine Group of Tampa, Florida offers a comprehensive fertility preservation program which includes freezing of gamates (sperm or eggs) and embryos. Current studies suggest that sperm, eggs, and embryos can be safely cryopreserved and thawed for future use without a significant health risk to the resulting children. Sperm cryopreservation is most common and has been available for several decades. Healthy pregnancies have been achieved from sperm that has been thawed more than 10 years after initial cryopreservation. Embryo cryopreservation has been available for more than 20 years. Improvements in embryo cryopreservation techniques have allowed for more embryos to survive the thaw process and implant. Children born from cryopreserved sperm, eggs or embryos have not been observed to have an increased incidence of congenital anomalies compared to the general population, suggesting that these technologies are reasonably safe and effective. Previously, oocyte (egg) cryopreservation was considered to be a more difficult procedure due to the inherent nature of the egg. Improved technologies have now made it possible to successfully freeze and thaw oocytes with pregnancy rates now equivalent to those of cryopreserved embryos, resulting in healthy children. All three cryopreservation programs are available at The Reproductive Medicine Group.
Approximately 50,000 reproductive age women in the United States are diagnosed with cancer each year. Earlier diagnosis and more aggressive treatment regimens have significantly improved survival and cure rates in children and adults with cancer. Although more effective, many of the current treatment regimens such as chemotherapy, radiotherapy and medications associated with bone marrow transplant are toxic to the human oocyte, resulting in infertility or sterility. As such, reproductive age women facing cancer treatments need to consider all of their options in terms of potential future fertility.
In addition, women with certain non-cancerous disorders may face potential sterility associated with their disease or the treatment of their disorder. Removal of one or both ovaries performed to treat a benign (non cancerous) tumor or conditions such as endometriosis can result in decreased fertility or in sterility. Women who test positive for the BRCA gene or who have a strong family history of ovarian cancer may elect to undergo prophylactic removal of the ovaries. Women with autoimmune diseases may be exposed to medications that are toxic to the oocyte or may experience premature (early) menopause. Finally, women who are age 30-40 and do not yet have a partner or for other personal or medical reasons need to delay pregnancy and wish to preserve their ability to have biologic children in the future, may choose to cryopreserve their eggs.
Previously, cryopreservation of embryos was the only option for women at risk for sterility due to the conditions outlined. However, cryopreservation of the human egg is now possible, becoming more common and is highly successful.
Oocyte cryopreservation requires retrieval (removal) of the eggs from the ovaries in the same manner as is performed for in vitro fertilization (IVF). Fertility medications are utilized to stimulate the development of multiple eggs within the ovaries. These medications are administered by subcutaneous (under the skin) injections for approximately 2 weeks to allow the eggs to reach maturity. Serial transvaginal ultrasounds (sonograms) and blood work are utilized to assess the development of the eggs. When these tests suggest that a reasonable group of eggs are likely to be mature, a final injection medication is given and then, 36 hours later, the woman receives complete sedation and the eggs are removed from the ovaries by placing a needle through the vaginal wall into each ovary using ultrasound guidance. The eggs are then frozen. The cost of oocyte cryopreservation is similar to the cost of an IVF cycle. Generally an annual fee is charged for storage of the cryopreserved ooctyes after the first year. Intracytoplasmic sperm injection (ICSI) is required to fertilize the thawed oocytes.
More than 1000 births resulting from cryopreserved oocytes have been reported with no increased rate of chromosomal or birth defects noted. The Reproductive Medicine Group has been highly successful both in egg freezing and achieving healthy pregnancies with the fertilization of cryopreserved eggs. No longer considered experimental, egg freezing is now a viable and highly successful procedure for women who are not yet ready to start their families but want to preserve their chances to conceive with their own eggs in the future.
Sperm cryopreservation is appropriate and available for several indications. Sperm can be frozen and stored at The Reproductive Medicine Group’s North Tampa location for short term use or shipped to a long term facility for later use. Sperm is often cryopreserved for men who anticipate undergoing chemotherapy, radiation therapy or certain surgical procedures to treat cancer. Some men undergoing vasectomy choose to cryopreserve sperm prior to the procedure. Couples who are actively attempting conception but anticipate that the husband will be geographically separated for an extended period of time may elect to cryopreserve sperm so that it is available when the woman is ovulating. Finally, for couples who are anticipating undergoing a cycle of IVF, if the male partner anticipates that he may have difficulty producing a semen specimen on the day of the female partner’s egg retrieval, sperm can be collected in advance under less stressful circumstances and cryopreserved. Generally, a single semen specimen can be divided into two or more vials or straws for storage purposes. Currently, the cost of semen cryopreservation is approximately $1200. Blood tests required to store the semen include: Men who are anticipating chemotherapy should contact our office as soon as possible to set up a collection appointment and blood work. Please call (813) 676-8867 to speak with our lab supervisor.
Embryo cryopreservation is available for couples undergoing in vitro fertilization (IVF) who produce more embryos than would be appropriate to transfer into the uterus at the time of the fresh cycle or for women who are anticipating chemotherapy, radiation or surgical removal of the ovaries and have a male partner or wish to use donor sperm. For couples undergoing IVF, approximately 25% will produce enough high quality embryos to place an appropriate number into the uterus during the fresh cycle and also have extra embryos of high quality to allow for cryopreservation. For women under the age of 38, 80-90% of cryopreserved embryos are anticipated to survive the thaw process and 50-60% of thawed frozen embryos transferred (FET) result in a pregnancy. For women age 38-40, pregnancy rates for fresh vs. FET cycles are equivalent. Interestingly, studies have demonstrated higher pregnancy rates achieved with FET compared to fresh cycle transfers in women above age 40. The cost of a FET cycle is significantly lower than a fresh cycle. While medications are necessary to prepare the uterus for frozen embryo transfer, fertility drugs which are costly are not required for a FET cycle. The approximate cost of embryo cryopreservation including the first year of storage fee is $1200. There is an additional annual storage fee for embryos that are not utilized within the first year of cryopreservation. The cost to utilize cryopreserved embryos including monitoring, embryology fees and embryo transfer is approximately $4500.