- Ovarian tissue freezing and transplantation is a fertility preservation option that allows young girls and women who risk losing fertility due to medical treatments like chemotherapy to preserve their eggs. Eggs are frozen through a process called vitrification. - Both males and females have options for preserving fertility prior to medical treatments like cancer therapy that could impact fertility. For females, these include embryo cryopreservation, oocyte cryopreservation, and ovarian transposition or cryopreservation. - While fertility preservation options exist, the choice of method depends on factors like a patient's age, type of disease, time available before treatment, and whether they have a partner. Oocyte cryopreservation is becoming more widely available but is still experimental

1. Fetal preservation
T.Usha kiran
Msc N Research scholar
Associate professor
OBG department

2. SUMMARY AND CONCLUSION
• Ovarian tissue freezing and transplantation is a
fertility preservation option, pioneered by Dr. Oktay,
for any young girl or woman who risks losing her
fertility due to chemotherapy, radiation, or
reproductive aging. Eggs are then frozen by a process
called vitrification.

3. fertility preservation
• people with certain diseases, disorders, and life events that affect
fertility may benefit from fertility preservation. These include
people who:
• Have been exposed to toxic chemicals in the work place.
• Have endometriosis
• Have uterine fibroids
• Are about to be treated for cancer
• Are about to be treated for an autoimmune disease, such as lupus
• Have a genetic disease that affects future fertility
• Delay having children

4. A number of fertility-preserving options are
available
• Fertility-preserving options for males include:
• Sperm cryopreservation: In this process, a male provides
samples of his semen. The semen is then frozen and
stored for future use in a process called cryopreservation.
• Gonadal shielding: Radiation treatment for cancer and
other conditions can harm fertility, especially if it is used
in the pelvic area. The testicles can also be protected
with a lead shield.

5. Fertility-preserving options for females include:
• Embryo cryopreservation. This method, also called
embryo freezing ,a health care provider removes
eggs from the ovaries. The eggs are then fertilized
with sperm from her partner or a donor in a lab in a
process called in vitro fertilization. The resulting
embryos are frozen and stored for future use.

6. Types
• Oocyte cryopreservation. This option is similar to
embryo cryopreservation, except that unfertilized
eggs are frozen and stored.
• Ovarian transposition. A health care provider
performs a minor surgery to move the ovaries and
sometimes the fallopian tubes from the area that will
receive radiation to an area that will not receive
radiation.

7. Options for fertility preservation
• Patient’s age
• Type of disease
• Spread of the disease
• Planned treatment
• Time available
• Whether she has a partner

8. IVF/Embryo Cryo

9. Cryopreservation of Embryos
• Requires medical stability, time, and partner/sperm, adequate
ovarian reserve
• Expensive, ethically problematic if patient dies
• Requires ovarian stimulation prior to systemic breast cancer
treatment- concerning in patients with hormone-sensitive
cancer
• Natural cycle IVF has low yield

10. Oocyte Cryopreservation
• Requires time and stimulation prior to treatment
• No requirement for sperm, less ethical concern
• Experimental- approximately 2% pregnancy rate
per thawed oocyte

11. Oocyte Cryopreservation
• Technically difficult
• oocytes: extremely sensitive to
temperature changes
• Crystal formation can cause
cytoplasmic damage
• Cryoprotectants
– depolymerize meiotic spindle
– cause aneuploidy
• Hardening of zona pellucida
– barrier to fertilization

12. Cryopreservation of Ovarian Tissue
• Requires surgical procedure to remove ovary or piece
of ovary
• May increase risk of infertility in low risk situation
• Potential for reintroduction of malignant cells at
reimplantation
• Highly experimental- few babies born to date

13. Ovarian Cryopreservation
• Ovarian cortex is frozen in thin slices
• Primordial follicles are less sensitive to
cryodamage because of
– low metabolic rate
– absence of zona pellucida
– high surface-volume ratio

14. Ovarian Cryopreservation
• Resumption of endocrine function has been reported
after orthotopic and heterotopic transplantation
• Embryo was generated from oocytes retrieved from sc
transplanted ovarian tissue
• Two live births reported after orthotopic
transplantation of frozen-banked ovarian tissue in
lymphoma survivors

15. Ovarian Cryopreservation
• Heterotopic tranplantation technique:
– Optimal site unknown
– Most have been to arm or forearm (or suprapubic area)
- No need for abdominal surgery
- Easy monitoring of follicular development
- Easy removal if necessary

16. Ovarian Cryopreservation
• Transplanting complete, intact ovary:
– Has been demonstrated in rats and sheep
– Recently demonstrated in human, but high risk
for ischemia-reperfusion injury
– No pregnancy demonstrated
(Bedaiwy M, et al, Hum Reprod, 2006)

17. Conclusion
• Oocyte cryopreservation appears to
be a feasible fertility preservation
method for reproductive-age women
diagnosed with cancer. This modality
is not only effective but also, providing
a multidiscipline effort, can be
completed in timely fashion.

18. conclusion
• Due to advancement in vitrification and rapid cooling
with a cryoprotectant, oocytes can now be
successfully frozen and thawed with rates of success
similar to those of embryos.
• Ovarian tissue cryopreservation is an experimental
option for pediatric, prepubertal cancer patients. The
goal of this method is to preserve eggs within the
primordial follicles in the ovarian cortex.

19. Pro’s and con’s of fertility preservation
• Pro’s:
• The technology has finally caught up with Women’s
desire.
• Freezing their eggs when they are young can alleviate the
anxiety and urgency.
• To the cancer patients
• To the children with cancer
• Who want to settle in there carreer ,education,right
match,setteling down.

20. Pro’s
• Women facing cancer treatment
• Women who need egg donars to conceive
• Women not able to conceive in the traditional senses or
not ready for conceiveing
• Having egg in the freezer can certainly take the pressure
particularly in 30’s
• Flash freezing egg in a technique called vitification for IVF
success.

21. Con’s
• Freezing egg is expensive -$ 5000-$10,000 price
• Statistically speaking pregnancy rates per egg are low-it
takes about 100 eggs to make one baby,so each egg there
is only1% chance of pregnancy
• Women go through five to ten stimulated cycles to
ensure 100 eggs are grown recovered and frozen
• Cytoplasmic sperm injection then there is 30% chances

22. Con’s
• Egg don’t always survive freezing-women waits into her
40’s
• Egg and embryos may not be the same after they are
frozen
• Egg freezing may come at the price to the next
generation(un known)
• Egg freezing may be the beginning of eugenics which
opens up a number of moral question
• Ethics of egg freezing

23. Thank you