Embryo (fertilized egg) freezing
How can this delay my treatment?
Embryo freezing takes about 2 weeks to complete.
Each month during ovulation, your ovaries usually release one egg. But when you freeze embryos for later use, your doctor will try to collect as many eggs as possible. To do so, you will give yourself hormones that encourage your ovaries to mature more than one egg.
The time from when you begin stimulation medicines until your egg retrieval can take anywhere from 10 to 15 days. After your eggs are collected by a doctor, the lab will fertilize them with sperm. In the following days, you will be told how many of your eggs successfully fertilized and how many embryos are frozen. In some cases, you can accomplish a cycle of embryo freezing after breast surgery and before any additional therapy begins. If you need chemotherapy before surgery, an embryo freezing cycle should be started as soon as possible for a minimal delay in starting chemotherapy.
How much will this cost?
Embryo freezing may cost between $10,000 and $15,000. The embryo freezing costs will vary based on the individual clinic that you are using.
Other costs may include yearly storage for the embryos and medicines for stimulation. When you are ready to use these embryos, having the eggs thawed and implanted can cost another $5,000. The total cost will vary depending on where you get care, what (if anything) your insurance will cover, and additional charges such as appointments, tests, and travel.
It is possible that the procedure may be covered by your insurance. To be sure, contact your insurance provider. If it is not covered by your insurance, you may be eligible for financial assistance through national programs that help aid in the cost of fertility preservation for cancer patients.
Can this interact with my hormone receptor-positive breast cancer?
There is no evidence that using hormones for the embryo freezing process affects hormone receptor-positive breast cancer.
To help prevent breast cancer from coming back, your doctor may recommend taking hormonal therapy for 5 to 10 years. If you want to attempt pregnancy during that time, speak with your doctor about safely taking a break from hormonal therapy while you get attempt pregnancy. Hormonal therapies can harm a fetus if taken during pregnancy. You should not attempt pregnancy while actively taking hormonal therapy.
Does my age impact this?
Because women are born with all the eggs they will ever have, the older a woman is, the more likely the eggs are to have problems that can lead to an increase in birth defects and miscarriage.
Some fertility centers restrict how old you can be when you attempt pregnancy. Be sure to ask your provider if there is an age limit for the transfer of a fertilized egg at your center.
Do I need a partner or sperm donor? Yes. After the egg retrieval, the eggs are fertilized in the laboratory and allowed to grow. Not all eggs will fertilize and not all fertilized eggs will continue to grow. The fertility doctor’s office will keep you updated on the progress of your embryos and when they are frozen.
If you use sperm from a partner, that partner will share rights over the embryos with you unless you’ve both signed a contract assigning all rights to you. When you are attempting pregnancy with a frozen embryo, both you and the partner used to create the embryos will need to sign additional consent forms. Sperm donors typically have to decline their rights when they donate, which means you alone have rights over the embryo if you use a sperm donor.
More about embryo (fertilized egg) freezing
The best time to go through embryo freezing is before breast cancer treatment begins. Stimulation involves giving yourself hormone injections for about 2 weeks. These medicines tell the ovaries to mature multiple eggs at once, instead of the single egg that is usually matured each month. Your fertility doctor may also have you take a medicine like tamoxifen or an aromatase inhibitor during stimulation, to try to decrease the rise in estrogen that occurs because of stimulation medicines.
To remove the eggs from your body, a doctor will insert an ultrasound device into your vagina to find the mature eggs stored in your ovaries. A needle is then guided into the ovary to remove each egg. The eggs are then fertilized in a lab, with sperm from your partner or a sperm donor. The fertilized egg will be allowed to grow, and if a healthy embryo develops it is frozen for use after breast cancer treatment and your oncology team has cleared you to attempt pregnancy or you choose to use a surrogate to carry the pregnancy.
If you have a family history of breast cancer or know you carry a gene mutation related to cancer, it is possible to test the embryo to see if it also carries the mutation. Your fertility specialist will have more information on these tests.
When you are ready to attempt pregnancy, the embryos are thawed and implanted into your uterus at your doctor’s office.
Egg or embryo freezing is the standard-of-care approach to preserve fertility.
It can be stressful to make decisions about fertility right after a breast cancer diagnosis. You may want to get started with cancer treatment quickly, or your doctors might recommend neoadjuvant therapy, chemotherapy before surgery. Perhaps you have not thought about having children yet, and cancer is now forcing you to do so.
Talk with your oncologist about timing and any concerns you have — there may be ways to make a schedule work for you and your treatment plan. Your oncologist can also communicate directly with the fertility doctor to ensure the delay to starting breast cancer treatment is minimal.