Why might I consider treatments to preserve my fertility?

You can consider fertility preservation treatments if you want to preserve your chance of having a baby in the future. Some reasons to preserve fertility are needing to delay having children until you're older or having treatment for a condition that may damage your natural fertility.

Delaying having children

Females who delay pregnancy for personal reasons may choose to freeze their eggs. This does not guarantee a baby, but might increase the chances of having a baby later in life. Some gender-diverse people consider fertility preservation treatment before transitioning. This keeps the option of having children in the future open.

Preserving fertility before cancer treatment

Some treatments for cancer or other health conditions can affect your natural fertility. It can reduce your chance of having a baby in the future. You might want to discuss your fertility with your doctor before you start cancer treatment.

What are my options if I want to preserve my fertility?

There are several ways to preserve fertility. Technology has created options for both males and females. The procedure your doctor recommends usually depends on why you need to preserve your fertility. A combination of two or more methods may be used.

Fertility preservation options for females

Freezing eggs

You can freeze your eggs to use later in life. The quality and number of eggs you have in your ovaries goes down as you get older. By freezing your eggs when you're younger, you can increase your chance of a successful pregnancy later on. When you are ready to get pregnant, the eggs you freeze can then be thawed, fertilised with sperm and developed into embryos in a lab. These embryos can then be transferred into your uterus.

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 already 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. This involves surgery to remove a small part of your ovary, which is frozen and stored in a special facility. It can be thawed and implanted back into your body later, when you're ready to get pregnant. About 9 months after the tissue is put back in your body, it can start to produce reproductive hormones again. At this stage your ovarian tissue can grow the follicles that have eggs inside.

Fertility preservation options for males

Freezing sperm

You can preserve your fertility by freezing your sperm. Sperm can be collected through masturbation in a fertility clinic or at home. It can also be collected through surgery called testicular biopsy. During the biopsy, sperm is collected directly through a needle. The sperm 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, sperm or embryo
• how many embryos are being transferred
• if the embryo had normal genetic screening

Australian and New Zealand data from 2023 showed there was around a 1 in 4 chance of having a baby after fertility preservation and a cycle of IVF and embryo transfer.

There are calculators available to help you estimate your chance of IVF success. However, it's best to speak to your doctor for an estimate that relates to your own 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. Some states provide rebates to make IVF more affordable. Ask your doctor about clinic options in your state or territory.

'You Can Fertility' helps cover the costs of fertility preservation for adolescents and young adults aged 13 to 30 years who are diagnosed with cancer in Australia. This service is managed 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.

What are the legal issues for fertility preservation?

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

Thinking about 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 rates. You can also access an online calculator to estimate your chance of success using IVF treatment.
• The Royal Women's Hospital in Melbourne has made 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.