Before cancer therapy, which step is recommended to preserve fertility?

• A. Oocyte or embryo cryopreservation prior to treatment
• B. Starting chemotherapy immediately
• C. Radiotherapy to preserve ovarian tissue
• D. Hysterectomy

Answer: (A)

Preserving fertility hinges on capturing viable reproductive cells before exposure to cancer treatments that can damage the ovaries. Freezing eggs (oocyte cryopreservation) or fertilized embryos (embryo cryopreservation) before starting therapy provides a bank of oocytes or embryos that can be used later to achieve pregnancy. This works because many cancer treatments, especially alkylating chemotherapy and pelvic radiotherapy, can cause permanent decreases in ovarian reserve or premature ovarian failure. By stimulating the ovaries to retrieve eggs and then vitrifying them, or creating and freezing embryos with sperm, patients maintain a real option for biological children after treatment. Other approaches that might be proposed, such as using radiotherapy to protect ovarian tissue or performing a hysterectomy, do not preserve fertility and can eliminate it, and starting chemotherapy immediately leaves little or no opportunity to pursue fertility preservation.