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Preservação da Fertilidade Feminina – Criopreservação de Ovócitos
Female fertility is a woman's ability to become pregnant. This ability is based on several factors, such as the quality of the oocytes, the successful implantation of the embryo in the uterus, and the healthy development of the fetus throughout the entire pregnancy.
Unlike men, women go through different reproductive phases throughout their lives, which ultimately influence their ovarian reserve. This begins to decrease from birth until menopause, reaching peak fertility at age 25 and experiencing a significant decline after age 35.
It is mainly after this age that fertility problems, miscarriages, or other complications in pregnancy and the fetus begin to arise, primarily due to the aging of the oocytes.
In today's society, due to various life circumstances, there is an increasing postponement of parenthood plans, which can lead to the difficulties mentioned above.
Oocyte cryopreservation, through the vitrification process, has allowed for the preservation of fertility in women who wish to postpone motherhood. This procedure gives them the opportunity to later use these cryopreserved oocytes at a younger age, maintaining the characteristics of that time. Therefore, the woman's age at the time of cryopreservation is a very relevant factor and should be discussed with the responsible physician, always bearing in mind that the earlier fertility preservation is performed, the greater the likelihood of success in future treatment.
Beyond the factor of postponing motherhood, fertility preservation plays a fundamental role in women diagnosed with cancer whose treatments may compromise their ovarian reserve and lead to premature ovarian failure.
In these cases, collaboration with the oncologist will allow the definition of the oocyte cryopreservation protocol in the most appropriate way for each patient's oncological situation.
Indicações:
- Women who intend to postpone motherhood for personal or family reasons;
- Women of reproductive age with oncological disease undergoing chemotherapy or radiotherapy treatments;
- Women suffering from a medical condition that may affect their ovarian reserve;
- In situations where, in an IVF/ICSI cycle, it was not possible to obtain a sperm sample from the partner;
- In cycles of low ovarian response, for oocyte accumulation.
Procedimento
Following an initial consultation and definition of a personalized protocol, treatment begins:
- Ovarian stimulation similar to that used in in vitro fertilization cycles: use of injectable hormonal medication (gonadotropins);
- Follicular puncture for oocyte retrieval;
- Oocyte screening and denudation to assess maturity: only mature oocytes can be vitrified;
- Oocyte vitrification: oocytes are cryopreserved in straws and stored in liquid nitrogen containers (at -196°C).
Vitrification is the method of choice for oocyte preservation, with survival rates exceeding 90%. However, these rates depend on oocyte quality, which is directly related to the woman's age.
According to Brazilian law, the maintenance period for oocyte cryopreservation is 5 years, renewable for successive 5-year periods, provided this is the patient's wish or until the oocytes are used.
When the time comes to use the oocytes, they must be devitrified and fertilized using the ICSI method. The resulting embryos will be cultured and monitored until the day of transfer, with a maximum of 2 embryos transferred to the woman's uterus.
It is important to emphasize that, although the clinical results are similar to the use of fresh oocytes, fertility preservation is not a guarantee of pregnancy, only a possibility of achieving it through treatment.
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