Stimulation Protocols For Fertility Preservation
Fertility preservation is advocated in couples who desire to postpone their pregnancy to later ages, in people who suffer from cancer and are undergoing chemo & radiotherapy; in couple who have been treated for immunological condition like SLE, multiple sclerosis, rheumatoid arthritis, etc.
Either egg freezing or embryo freezing can be done. If the male partner is affected, semen freezing can be done- multiple samples with proper intervals can be given to the lab for freezing.
Ovarian stimulation can be done from any day of the cycle (Random start COS).
Recently a developed ovarian stimulation protocol uses standard medicines with GnRH, which is safe in cancer patient because it does not cause hyper estrogenic environment.
Oncology patients are at increased risk of thromboembolic events (clots in the veins) due to high E2 as well as due to malignancy. So anticoagulants should be given.
in liver cancer & bone marrow cancer, to avoid excessive bleeding, fresh frozen plasma transfusion or platelet transfusion can be given prior to oocyte retrieval.
During cancer treatment, ovarian suppression can be done with GnRH agonist injection to preserve the ovarian function.