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Neo Vita - Human Reproduction and Reproductive Health

Technical Manager: Dr. Fernando P. Ferreira

CRM-SP: 103.984 | RQE: 39.163.1

Preservation of fertility

HOW TO GET PREGNANT AT THE RIGHT TIME OF LIFE?

With the profound changes that our society has undergone, especially after the 1960s of the 20th century, a women won her position in the job market. In parallel, the most effective contraceptive methods (mainly the pill) emerged, which allowed women to decide when, how and how many children she will have in her life.

The woman, before having children, studies, completes university education, assumes important positions in the companies where she works and reaches her financial stability. Only after that do the plans to have children come up, around 35 or 40 years old.

The main problems at this stage of life are the quality and quantity of the eggs. With each menstrual cycle, the best egg to be fertilized is selected, and the remaining  eggs start to atrophy. The woman is born with all her stock of defined eggs  (limited number of eggs) and decreases  until it is completely gone. When the supply runs out, menopause arrives.

The quality of the eggs is maximum around the age of 25 and remains very high until the age of 35. From this age, we noticed a reduction in the chances of getting pregnant, which is accompanied by greater risks of miscarriages, genetic syndromes and malformations.

In the very moment of personal and professional life, women find their chances of becoming pregnant reduced and their risks increased. It is quite a problem.

There are safe and effective methods that allow the preservation of fertility, before women lose quality and quantity of eggs and guaranteeing low risks of malformations and genetic syndromes.

Some techniques, now well established by researchers, have brought new expectations to preserve the fertility of women undergoing treatments that impair fertility, such as chemotherapy for cancer. The chemical agents used in these treatments act on all cells in the body, including germ cells (gametes), which can be completely destroyed after treatment, leading to female infertility.

Today science offers different techniques for these patients, whether they are undergoing health treatment or simply wanting to postpone motherhood. These include:

CRYOPRESERVATION OF OOCYTES (OVULES):

The first case of a child’s birth after thawing oocytes and subsequent “in vitro” fertilization was in 1986. In these cases, a fundamental indicator is the patient’s age, due to the very poor quality of this cell after 40 years of age.  The procedure is performed in the laboratory, where patients are induced to produce more follicles than in a natural cycle. Once these follicles reach an appropriate size, they are punctured by a specialist doctor, through a transducer with a needle attached and frozen in an embryology laboratory. Some recent studies have indicated post-thaw oocyte survival rates of up to 96%, with a 73% fertilization rate, 38% uterine implantation rate per embryo and up to 63% gestation.

We recommend freezing eggs for women without a steady partner, single or who are not sure they have found the ideal partner. By freezing the eggs, she may decide in the future to fertilize them with the partner’s semen or even with donor bank semen.

EMBRYO FREEZING:

We can also freeze embryos. For that, we need a partner or even a semen bank. It is a good technique for women who are married or in stable relationships. Eggs and embryos can be frozen indefinitely, even decades. When the time is right to start a family and have children, the woman can thaw the eggs or embryos and become pregnant. The chances of success will be identical to the age at which they were frozen and this also applies to the risks of miscarriage or syndromes. The younger you are, the greater the chances of success and less risk.

Through in vitro fertilization, the egg and sperm are fertilized in the laboratory, after the embryo’s development, it will be frozen in liquid nitrogen at -196ºC, remaining so until the responsible couple comes to remove this embryo from nitrogen for future pregnancies donation to other couples, scientific research, or disposal. Ideally, women should freeze at least 10 eggs or 4 embryos, as we have minimal losses in thawing and embryonic  development embryos.

OVARIAN TISSUE FREEZING:

Procedure performed through videolaparoscopy (minor surgery), by which freez fragments of ovarian tissue, which in the future will be placed in the ovaries that have lost the function of producing eggs. It is indicated for children who have not yet reached puberty, or adult patients who will undergo chemotherapy or radiotherapy therapy. It is still an option that offers small success rates, but can be indicated when there is no other more suitable alternative.

TRANSPOSITION OF THE OVARIES:

It is also indicated for the preservation of female fertility when some patients are submitted to radiotherapy treatment, and can be directly affected by radiation toxic to the function of the ovaries. It is nothing more than a surgical procedure (videolaparoscopy), which will place the ovaries behind the uterus during the treatment period or in another place far from the site that will be reached by the radiation, after the radiotherapy treatment the ovaries can return to their proper place with minor surgery, ensuring the fertility of these patients.

Finally, science can help women adapt to the new reality of society. If she has a serious health problem, she can preserve her fertility, heal herself and think about pregnancy in the future. The woman can also study, work and stabilize herself financially keeping her fertility preserved. The dream of being a mother no longer needs to be a conflict between professional career and personal life.

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