Why might I consider treatments to preserve my fertility?

There are many reasons why you may choose to delay starting a family. You may not be ready or able to try for a baby right now, and want to keep your options open. If so, you can consider the options available to preserve your fertility.

Delaying starting your family

Females who delay starting a family for personal reasons may choose to freeze their eggs. This does not guarantee a baby, but it can increase their chances of having a baby later in life. Some gender-diverse people may also consider fertility preservation before transitioning, to keep the option open of having a family in the future.

Preserving fertility before cancer treatment

If you need treatment for cancer or another health condition that might involve medicines or a procedure, this could affect your chances of having a baby. If so, you might want to discuss fertility preservation with your doctor before you start treatment.

What options are there for me to preserve my fertility?

There are many ways to preserve fertility, and technology has created options for both males and females. The procedure your doctor recommends usually depends on why you need to preserve your fertility.

Fertility preservation options for females

Freezing eggs

You may choose to freeze your eggs to use later in life. The quality and number of eggs you have in your ovaries goes as you get older. By freezing and storing your eggs when you’re young, you can increase your chance of a successful pregnancy later on. The eggs can then be thawed, fertilised with sperm and developed into an embryo, to be used in the future.

Freezing embryos

You may choose to freeze embryos (eggs that have already been fertilised by sperm) for later use. This is often the preferred method if you have a male partner. The eggs are fertilised by your partner’s sperm, and frozen to be implanted later.

Freezing ovarian tissue

Your doctor may advise you to consider freezing ovarian tissue before you have chemotherapy. This involves surgery to remove a small part of your ovary, which is frozen and stored. It can be thawed and implanted back into your body later, when you’re ready to be pregnant. The aim is for the tissue to produce hormones and eggs in the future.

Fertility preservation options for males

Freezing sperm

You can preserve your fertility by freezing sperm. Sperm can be collected through masturbation in a fertility clinic or at home. It can also be collected through surgery called testicular biopsy, where the sperm is collected directly through a needle. The sample is then frozen to fertilise eggs in the future.

What are my chances of conceiving after fertility preservation treatment?

Success rates for IVF using egg or embryo freezing vary widely, based on many things such as:

• your age
• your lifestyle and medical background
• the quality of the egg or embryo
• how many embryos are being transferred
• if the embryo had normal genetic screening

The most recent data from Australia and New Zealand gives an overall chance of successfully having a baby after fertility preservation of between 25% and 40%.

There are calculators available to help you estimate your chance of IVF success, but it is best to speak to your doctor for an estimate that best reflects your situation.

How much do fertility preservation treatments cost?

In Australia, fertility treatments, including preservation, can be expensive.

Medicare or private health insurance might cover part of the cost. You will need a referral from your doctor for fertility preservation treatment. Most people will also need to pay some fees out-of-pocket.

The fee depends on:

• which services you need
• how much your doctor charges
• whether you have private health insurance

Some states in Australia have established lower cost IVF clinics and some provide rebates to make IVF more affordable. Ask your doctor about clinic options in your state or territory.

‘You Can Fertility’ covers the costs of fertility preservation for adolescents and young adults aged 13 to 30 years who are diagnosed with cancer in Australia through The Royal Women’s Hospital in Melbourne. Fees for treatments you may need and storage fees are still charged, and are not reimbursed by Medicare.

Speak to your doctor, your fertility clinic and your health insurer to find out what the different costs are. Check if Medicare or your private health insurance will cover your costs, and what you will need to pay out of pocket.

Is fertility preservation available to everyone?

Access to assisted reproductive technologies (ART), such as fertility preservation, is guided by both state and national laws. Clinics must follow these laws to be nationally accredited. Unreasonable or unlawful discrimination against individuals and couples to stop them from accessing fertility preservation is not allowed.

Does fertility preservation involve any legal issues?

Fertility clinics must follow Australian law and ethical guidelines. These cover the collection and storage of eggs, sperm and embryos for fertility preservation and treatment. There may be some differences between Australian states and territories. Your doctor or fertility clinic will be able to help you understand your options and opportunities.

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Resources and support

Fertility preservation can be overwhelming, especially if you are also dealing with a cancer diagnosis. It can help to talk with your doctor and others in your medical team for advice and support.

• Your IVF Success can help you locate IVF clinics in your area and show you their success rate. You can also access an online calculator to estimate your chance of success using IVF treatment.
• The Royal Women’s Hospital, Victoria has produced a video on treatment options for fertility preservation during cancer treatment.
• You can call the Cancer Council on 13 11 20 for telephone support and to learn more about the services available.