Embryo and Oocyte Banking

Abstract

For women of reproductive age who are scheduled to undergo medical treatment that could lead to premature decline of ovarian function, embryo and oocyte cryopreservation—or “banking”—are the most commonly used fertility preservation options. Embryo cryopreservation (i.e., standard in vitro fertilization) before chemotherapy is the most well-established and widely available method of fertility preservation. Both embryo and oocyte banking require controlled ovarian hyperstimulation and oocyte retrieval over a period of approximately 12–14 days; thus, these techniques are only appropriate if chemotherapy can be postponed without compromising the patient’s treatment outcomes. Classic and modified controlled ovarian hyperstimulation protocols are described as well as the costs, success rates, and potential risks of the procedures, such as ovarian hyperstimulation syndrome and intra-abdominal bleeding, which must be weighed in the context of the cancer patient’s overall health status. The methods of oocyte cryopreservation currently in use slow freezing and vitrification, and the success rates of each are also discussed. This chapter concludes with a review of tumor-specific considerations for the use of embryo or oocyte banking for patients with breast cancer, ovarian cancer, hematologic malignancies, endometrial cancer, and cervical cancer.