Fertility treatment for women
There are different kinds of fertility treatment for women.
If you aren’t producing eggs
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If you’re not producing any eggs at all, you won’t be able to have your own biological child unless you stored embryos or eggs before your cancer treatment. You may be able to use donated eggs or embryos.
Using frozen embryos
When the frozen embryos are needed, they are unfrozen (thawed) and placed in the womb to see if they will implant and develop. This is usually done one embryo at a time. Both you and your partner, whose sperm was used to make the embryo, must give consent to do this.
Before your embryos are frozen, it’s important you find out whether your IVF unit uses vitrification or slow freezing. Vitrification is just as effective as using fresh embryos to get pregnant. But not all IVF units use this method, and instead use slow freezing because it’s cheaper. With slow freezing, pregnancy rates are generally lower.
Using frozen eggs
When the frozen eggs are needed, they are thawed and can be fertilised by mixing them with sperm in a laboratory. The sperm may be from your partner or a donor.
In the past, the chance of a successful pregnancy from frozen, unfertilised eggs was very low because of the technology used to freeze the mature eggs. However, a new technology called vitrification means that the pregnancy rates from vitrified mature eggs are now as good as fresh eggs. Not all IVF units can perform vitrification on eggs so it is important that you speak to a specialist who can offer this.
Using frozen ovarian tissue
A new and experimental technique is to take and store samples of ovarian tissue that contain many eggs. The ovarian tissue can then be put back into the body at a later date. This technique is at a very early stage of development and hasn’t been widely used.
If you’re suitable for this procedure, you’ll probably have to travel to a specialist hospital for it.
Using donated eggs or embryos
If you don’t have any frozen embryos or eggs, the only fertility treatment available is to use eggs or embryos that have been donated by someone else.
People who donate eggs or embryos are carefully chosen. Their general health is checked and they’re offered counselling to make sure they understand exactly what it means to help infertile people in this way. Occasionally, it might be possible to use a donor that you know, such as a sister or friend. But this also requires careful thought and counselling for everyone involved.
If you decide to have fertility treatment using eggs or embryos from a donor, you will
also be offered counselling and information about what it involves. There can often
be a waiting list for this treatment.
Using donated eggs
If your partner is fertile, you may be advised to have treatment using donated eggs.
The donated eggs are fertilised with your partner’s sperm in the laboratory.
The embryos that are formed are then put into your womb. You’ll need to have treatment with hormones before the embryos are implanted, and during the early part of the pregnancy.
Because egg donors are usually young women with good fertility, the chances of
a successful pregnancy with this treatment are quite high.
Using donated embryos
If both you and your partner have a fertility problem, you may be advised to try using donated embryos (eggs that have already been fertilised by sperm, and then frozen). The embryos are thawed and put into your womb. You’ll need to take hormones before the embryos are implanted, and possibly during the pregnancy.
If you can’t have a pregnancy yourself
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Some women aren’t able to have a pregnancy because their womb has been removed by surgery, or pelvic radiotherapy has damaged the lining of the womb. In this situation, surrogacy is an option. Surrogacy is where another woman, called the surrogate (or host), becomes pregnant and gives birth.
If you are able to use your own eggs, an embryo is made by fertilising your eggs with your partner’s sperm (or with donated sperm). This is done using IVF. The embryo is placed in the surrogate’s womb and she will carry the pregnancy.
If you are unable to use your own eggs, IVF can be carried out with donated eggs, which could be from the surrogate or another woman.
Another option is for the surrogate to be ‘inseminated’ with your partner’s sperm (or donated sperm). The sperm is frozen until it’s needed. The surrogate will have tests and scans to monitor her menstrual cycle and show when she is about to release an egg. When the egg is about to be released, the sperm is thawed and placed into the surrogate’s womb, with the hope of fertilising her egg. This option always involves using the surrogate’s own eggs.
In this case, the surrogate mother is the legal mother of the baby, but you and your partner can apply to the courts to have full parental legal responsibilities transferred to you (providing you are married or in a civil partnership). This means you become the baby’s legal parents. If you and your partner aren’t married, it is still possible to adopt the baby but it is slightly more complicated. In all cases, it’s important to involve a lawyer who specialises in surrogacy so they can guide you through how to adopt the baby.
If you can’t have sexual intercourse
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Some people can’t have sex because of physical changes caused by the cancer or its treatment. It may be possible for the doctors to take your eggs and use them in IVF or ICSI treatment. This can allow you to have your own biological children. Where this isn’t possible, you may want to think about using donated eggs or embryos or surrogacy.
What if the treatment doesn’t work?
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It’s always upsetting if the treatment fails. The doctors at the clinic can advise you on what your chances of success might be if you tried again. Whether you have another fertility treatment will depend on whether it feels right for you, emotionally. There may also be other issues to consider, including whether or not you have to pay.
Counsellors in fertility clinics can help by talking to you about everything. There are also support groups for people who have decided to end fertility treatment when they haven’t achieved a pregnancy, such as Infertility Network UK.