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When is it necessary?

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Before patients (either male or female) can receive fertility preservation, they must be carefully evaluated. It is a multidisciplinary assessment; that is, under the control of both the reference doctor (an oncologist in most cases) and the doctor specialising in reproductive medicine. Below are the main points in the clinical assessment:

The clinical situation of the patient; that is, the stage of the disease (how advanced it is) and prognosis; as well as the risk involved in carrying out these preservation techniques.

The therapeutic plan and the time available before the start of treatment.

Patient age, the ovarian reserve status and the degree of danger of the indicated treatment.

The risk of ovarian dysfunction is the main criterion for determining whether or not fertility preservation is performed. Ovarian failure occurs when a woman's ovaries stop working normally before she is 40 years old.

OVARIAN RESERVE

The ovarian reserve is the quantity and quality of the ovules that a woman has at a given moment in her life. The eggs are found inside small ovarian cysts called follicles. Fertility in women is known to decrease with advancing age, for two main reasons:

- Follicular loss: little by little, follicles are lost as the woman ages. The growth and decline of these follicles begins before birth, and continues throughout the years until ending at the time of menopause. From puberty, with the onset of menstruation, a mature egg capable of resulting in a pregnancy is produced each month.

- Ovarian quality: Ovule quality decreases with age, making it more difficult to achieve a pregnancy and with a higher risk of miscarriage. This is due to progressive ageing of the ovules.

Thus, the probability of a woman getting pregnant (either spontaneously or through assisted reproduction treatments) clearly decreases with age.

The reference doctor informs the patient of the possible effects on fertility of oncological and immunological treatment, for example. Meanwhile, the doctor specialising in reproductive medicine indicates the most appropriate preservation technique from the two main options, based on a risk assessment and individual features: