- Protect Your Future Family
Fertility Preservation: Protecting Your Future Fertility Through Egg, Embryo and Sperm Freezing
Fertility preservation is the process of storing eggs, embryos, sperm, or ovarian tissue to protect future fertility. It is recommended for patients facing medical treatments that threaten fertility such as chemotherapy, radiotherapy, or surgery, and increasingly for healthy individuals who wish to delay parenthood without compromising their chances of having biological children. At Samarth IVF, we offer comprehensive fertility preservation including egg freezing (oocyte cryopreservation), embryo freezing, sperm freezing, and ovarian tissue cryopreservation across 14 centres in India.
What is Fertility Preservation?
Fertility preservation encompasses any strategy designed to maintain the ability to have biological children at a future time. The most established and effective methods involve cryopreservation, the controlled freezing and storage of reproductive cells or tissue using vitrification technology. When the person is ready to attempt pregnancy, the stored material is thawed and used to create embryos through IVF, which are then transferred to the uterus.
Fertility preservation has transformed from a niche oncological service to a mainstream component of reproductive medicine. The introduction of vitrification (ultra-rapid flash freezing) dramatically improved the survival of frozen eggs after thawing, making egg freezing a clinically effective option for the first time. Previously, eggs were poorly suited to slow-freeze cryopreservation due to their large size and high water content. Vitrification solved this problem, producing post-thaw survival rates above 85 to 90 percent and pregnancy rates comparable to fresh egg IVF.
Why Does Fertility Decline With Age?
Women are born with all the eggs they will ever have, approximately 1 to 2 million at birth. By puberty this falls to around 300,000 to 400,000. Only 400 to 500 eggs will ever be ovulated during a lifetime. The rest undergo atresia (programmed cell death) continuously throughout life. The rate of this decline accelerates significantly from around age 35 to 37. By age 40, both the quantity and quality of remaining eggs are substantially reduced.
Eggs frozen at age 30 retain the chromosomal quality of age 30 eggs when thawed and used years later. This is the fundamental biological rationale for fertility preservation: freezing eggs at a younger age preserves that younger egg quality for future use, regardless of when the person is ready to attempt pregnancy.
- Preservation Methods
Types of Fertility Preservation at Samarth IVF
Depending on your medical situation, relationship status, and timeline, our experts will recommend the most effective preservation strategy for you.
1. Egg Freezing (Oocyte Cryopreservation)
Egg freezing is the most established fertility preservation method for women without a male partner or for those who do not wish to create embryos at this stage. The process involves controlled ovarian stimulation with hormone injections (the same stimulation used in IVF) to develop multiple eggs, followed by egg retrieval under sedation, and vitrification of the mature eggs in the embryology laboratory.
Duration:
An egg freezing cycle takes approximately 2 weeks from the start of stimulation to egg retrieval.
Number of eggs recommended:
Women under 35 typically need 10 to 15 mature eggs per desired child. Women 35-37 need 15-20. Women above 38 may need 20+ (multiple cycles may be required).
Survival after thaw:
Above 85 to 90 percent of vitrified eggs survive thawing at Samarth IVF.
Fertilisation after thaw:
Thawed eggs are fertilised using ICSI (not standard IVF) as the zona pellucida undergoes changes. ICSI fertilisation rates of 70 to 80 percent per thawed mature egg are achieved.
Storage:
Vitrified eggs are stored in liquid nitrogen at minus 196 degrees Celsius. Storage can be maintained for many years with no deterioration in egg quality.
2. Embryo Freezing
Embryo freezing is the most established and highest-success fertility preservation option for women or couples who have a male partner at the time of preservation. Eggs are retrieved using the same IVF stimulation process, fertilised with partner or donor sperm in the laboratory, cultured to the blastocyst stage, and the resulting embryos are vitrified for future use.
- Success rates: Frozen embryo transfer (FET) cycles using vitrified blastocysts achieve pregnancy rates of 45 to 55 percent per transfer for women who preserved embryos under age 35.
- Advantage over egg freezing: Embryos are more robust to vitrification than eggs. Embryo survival rates after thawing are above 95 percent. Embryo freezing is the preferred option when a partner is available.
- Legal and ethical considerations: Frozen embryos are jointly owned by both partners. Decisions about storage, use, donation, or disposal must be agreed by both. This is an important consideration for couples who may separate in the future.
- Onco-fertility use: For female cancer patients with a partner, embryo freezing before cancer treatment is the most reliable fertility preservation option available.
3. Sperm Freezing
Sperm freezing is the simplest, least invasive, and most long-established fertility preservation method. A semen sample is provided, processed to concentrate and select the best sperm, and the prepared sample is divided into multiple vials and vitrified for storage. Stored sperm can be used for IUI, IVF, or ICSI at any point in the future.
- Indications: Cancer treatment, surgery affecting ejaculatory function, progressive deterioration in semen parameters, planned vasectomy, or military deployment.
- Number of vials: Multiple vials are stored from a single sample to provide for multiple future treatment attempts.
- Recovery after cancer treatment: Sperm production often recovers after chemo/radiotherapy, but recovery is not guaranteed, takes 1 to 2 years, and may be incomplete. Freezing before treatment is strongly recommended.
- Surgical sperm freezing: For men with azoospermia, sperm retrieved surgically via TESA, PESA, or micro-TESE can be frozen for future IVF-ICSI use.
4. Ovarian Tissue Cryopreservation
Involves removing a portion of the ovarian cortex (the outer layer of the ovary, which contains thousands of primordial follicles with immature eggs) by laparoscopic surgery, slicing it into thin strips, and vitrifying these strips for future use. When ready, the tissue is thawed and transplanted back onto the remaining ovary or into the pelvic cavity, where it re-establishes blood supply and resumes producing hormones and developing follicles.
Particularly valuable for prepubertal girls who have not yet undergone puberty and for whom egg or embryo freezing is not possible. Also the fastest option for adult women who cannot delay cancer treatment long enough for a full stimulation cycle. Now classified as an established rather than experimental technique.
Limitation: Carries a theoretical risk of reintroducing cancer cells when the tissue is transplanted back in patients with certain haematological malignancies such as leukaemia. In these cases, in vitro maturation may be considered.
3. Sperm Freezing
IVM involves retrieving immature eggs from unstimulated or minimally stimulated ovaries and maturing them in the laboratory before freezing.
IVM avoids ovarian stimulation entirely, making it suitable for patients with hormone-sensitive cancers such as oestrogen-receptor positive breast cancer, where stimulation with gonadotrophins is contraindicated or undesirable, and for patients who cannot delay cancer treatment for the 2 weeks required for a stimulation cycle.
Mature rates and outcomes with IVM are lower than with conventional stimulation but it provides an option where conventional egg freezing is not feasible.
- Preservation Methods
Medical Indications for Fertility Preservation (Onco-Fertility)
Medical fertility preservation is undertaken when a medical diagnosis or planned treatment poses a significant risk to future fertility. This is the most urgent category of fertility preservation.
At Samarth IVF, we prioritise onco-fertility referrals and aim to complete fertility preservation cycles as rapidly as possible to avoid delaying life-saving treatment.
Cancer and Chemotherapy
Chemotherapy, particularly alkylating agents such as cyclophosphamide, ifosfamide, melphalan, and busulfan, is profoundly gonadotoxic. These agents damage the primordial follicle pool in women and the spermatogonial stem cells in men, potentially causing premature ovarian insufficiency (POI) in women and azoospermia in men. The degree of gonadotoxicity depends on the specific drugs, doses, and duration of treatment.
All patients of reproductive age who are about to undergo potentially gonadotoxic chemotherapy should be referred for urgent fertility preservation counselling before treatment begins. Even when the urgency of treatment is high, the 2-week window for egg or embryo freezing can usually be accommodated without compromising cancer outcomes in most solid tumour types. Your oncologist and Samarth IVF specialist will work together to optimise the timing.
Pelvic Radiotherapy
Radiotherapy directed to the pelvis, abdomen, or spine above the pelvis can damage the ovaries and uterus. Ovarian transposition (oophoropexy), moving the ovaries out of the radiation field before radiotherapy, can reduce ovarian radiation exposure. Ovarian or embryo cryopreservation before radiotherapy provides additional protection. Uterine damage from pelvic radiotherapy may reduce the capacity for future pregnancy even if ovarian function is preserved.
Planned Surgical Removal of Ovarian Tissue
Women facing bilateral oophorectomy (surgical removal of both ovaries) for large bilateral endometriomas, ovarian torsion, or other benign conditions benefit from fertility preservation before surgery. Even women facing unilateral oophorectomy benefit from egg or embryo freezing if the contralateral ovary has reduced reserve or if future ovarian failure is a concern.
Genetic Conditions Causing Premature Ovarian Insufficiency
Women carrying the FMR1 premutation (fragile X carrier) have a significantly elevated risk of premature ovarian insufficiency before age 40. Early referral for fertility preservation counselling and egg or embryo freezing before reserve declines is strongly recommended. Turner syndrome (45,X) is associated with rapid ovarian failure in adolescence and early adulthood. In selected cases, fertility preservation in adolescent Turner syndrome patients may be possible before reserve is exhausted.
- Empowering Choices
Social Fertility Preservation: Egg Freezing to Delay Parenthood
Social fertility preservation, also called elective egg freezing, refers to egg freezing by healthy women who wish to delay parenthood for personal, professional, or relationship reasons without a specific medical indication. It is the fastest-growing indication for egg freezing globally and is increasingly chosen by women in their late 20s and early 30s who are not yet ready for parenthood but want to protect their future options.
The Biological Rationale
The biological rationale is clear and compelling. Eggs frozen at age 30 retain the chromosomal quality and developmental potential of age 30 eggs. If those frozen eggs are used at age 38, the pregnancy rates and miscarriage rates will reflect the quality of age 30 eggs, not age 38 eggs.
Social egg freezing is therefore most effective when done early, ideally before age 35 and optimally between ages 28 and 33, when ovarian reserve is still high and egg quality is at its best.
Realistic Expectations for Social Egg Freezing
Social egg freezing is not a guaranteed insurance policy. It improves future fertility options but does not guarantee a future pregnancy. Success depends on the age at freezing, the number of eggs frozen, the quality of the eggs, and the woman's health and uterine function at the time of future use. Counselling at Samarth IVF provides honest, personalised information about expected outcomes based on each patient's AMH, AFC, and age.
Age under 35
Each frozen mature egg has approximately a 5 to 7 percent chance of resulting in a live birth. 10 to 15 eggs frozen at this age give a reasonable cumulative probability of success.
Age 35 to 37
Per-egg live birth probability reduces to 3 to 5 percent. 15 to 20 eggs are recommended.
Age 38 to 40
Per-egg probability is 2 to 3 percent. Multiple stimulation cycles may be required to freeze sufficient numbers.
Above 40
Per-egg probability is low. Social egg freezing at this age has limited effectiveness. Counselling will address whether egg donation is a more realistic option.
The Egg Freezing Process at Samarth IVF:Step by Step
Step 1: Initial Consultation and Ovarian Reserve Assessment
Your Samarth IVF specialist reviews your menstrual history, general health, and any relevant medical history. A baseline transvaginal ultrasound measures the antral follicle count (AFC) and AMH blood test assesses ovarian reserve. Together these give a personalised prediction of the likely number of eggs retrievable per stimulation cycle and guide the recommended total number of eggs to aim for based on your age and future family plans.
Step 2: Ovarian Stimulation
Daily subcutaneous injections of FSH or FSH with LH begin on Day 2 to 3 of the menstrual cycle. The stimulation protocol is selected based on AMH, AFC, age, and any history of previous stimulation. Serial transvaginal ultrasound scans every 1 to 2 days monitor follicle development. Doses are adjusted as needed. Stimulation continues for 10 to 12 days until the leading follicles reach 17 to 18 mm.
Step 3: Trigger Injection and Egg Retrieval
When 2 or more follicles reach 17 to 18 mm, a trigger injection is given. For patients with PCOS or high follicle counts, a GnRH agonist trigger is used to eliminate OHSS risk. Egg retrieval is performed exactly 36 hours after the trigger injection under intravenous sedation as a day-procedure. Follicles are aspirated transvaginally under ultrasound guidance and the embryologist identifies each egg in the adjacent laboratory.
Step 4: Egg Assessment and Vitrification
Retrieved eggs are assessed under the microscope. Only mature (MII stage) eggs are suitable for vitrification and future fertilisation. Immature eggs (GV and MI stage) are not frozen as their developmental potential after thawing and maturation is significantly lower. Mature eggs are vitrified using the Cryotech or Kitazato vitrification system and stored in liquid nitrogen at minus 196 degrees Celsius.
Step 5: Storage
Vitrified eggs are stored in clearly labelled, double-identified cryostorage straws within liquid nitrogen tanks in the Samarth IVF cryobank. Annual storage fees apply. Eggs can be stored for many years with no deterioration in quality. Regular monitoring of tank temperatures, liquid nitrogen levels, and cryostorage security is maintained by trained laboratory staff.
Step 6: Using Frozen Eggs in the Future
When the patient is ready to attempt pregnancy, a consultation is arranged to plan the frozen egg thaw and fertilisation cycle. Frozen eggs are thawed, fertilised using ICSI with partner or donor sperm, and cultured to the blastocyst stage. The best quality blastocyst is then transferred to the uterus in a prepared FET cycle. Any additional blastocysts are frozen for future use.
Fertility Preservation for Men
Male fertility preservation is simpler and more established than female fertility preservation. Sperm are far more amenable to cryopreservation than eggs. Sperm freezing can be completed in a single visit without any hormonal stimulation or surgical procedure (for ejaculated sperm). All men facing potentially gonadotoxic medical treatment should be offered sperm freezing before treatment begins.
Sperm Freezing Process
A semen sample is provided by masturbation after 2 to 5 days of abstinence. The sample is processed using density gradient centrifugation to select the best quality sperm. The prepared sample is divided into multiple vials (typically 5 to 10 depending on the total motile count) and each vial is vitrified separately. Frozen vials are stored in liquid nitrogen in clearly labelled cryostorage straws. Each vial contains sufficient sperm for one IUI, IVF, or ICSI cycle.
Surgical Sperm Freezing
For azoospermic men or men who cannot produce an ejaculated sample, sperm retrieved surgically via TESA, PESA, or micro-TESE can be divided and frozen in multiple vials. This allows a single surgical retrieval to provide sperm for multiple future ICSI attempts without repeat surgery.
Important note on Onco-fertility for men:
Sperm production often recovers after chemotherapy or radiotherapy, but recovery is not guaranteed, takes 1 to 2 years, and may be incomplete or of reduced quality. Freezing sperm before treatment is strongly recommended as it provides a certain, quality-preserved sample that does not depend on recovery.
Fertility Preservation
Samarth IVF Centres in India
Fertility preservation services including egg freezing, embryo freezing, sperm freezing, and ovarian tissue cryopreservation are available at Samarth IVF centres with full IVF laboratory and cryopreservation infrastructure. Urgent onco-fertility cases are prioritised across all main centres.
Sambhajinagar (Aurangabad), Maharashtra: Main HQ with full surgical and IVF facilities, plus 2 Level-1 Centres
Washim, Maharashtra | Buldhana, Maharashtra | Parbhani, Maharashtra | Omerga (Umarga), Maharashtra | Gondia, Maharashtra
Dehradun, Uttarakhand | Jamnagar, Gujarat | Kalaburagi (Gulbarga), Karnataka | Bhopal, Madhya Pradesh | Farrukhabad, Uttar Pradesh | Lucknow, Uttar Pradesh
- FAQ
FREQUENTLY ASKED QUESTIONS
Fertility preservation is the process of storing eggs, embryos, sperm, or ovarian tissue to protect the ability to have biological children in the future. It is recommended for patients facing medical treatments that threaten fertility such as chemotherapy, radiotherapy, or surgical removal of ovarian tissue, and for healthy individuals who wish to delay parenthood. Options include egg freezing, embryo freezing, sperm freezing, and ovarian tissue cryopreservation.
Egg freezing success depends primarily on the age at freezing and the number of eggs stored. In women under 35, each vitrified mature egg has approximately a 5 to 7 percent chance of resulting in a live birth. Freezing 10 to 15 mature eggs under age 35 provides a reasonable cumulative probability of success. Success rates decline with age. Eggs frozen before age 35 consistently outperform eggs from the same woman used fresh at an older age, confirming the biological benefit of early preservation.
Egg freezing stores unfertilised eggs, which can later be thawed, fertilised with partner or donor sperm, and used for IVF. It does not require a partner at the time of freezing and gives more flexibility. Embryo freezing stores embryos that have already been fertilised with partner sperm. Embryos have higher post-thaw survival rates above 95 percent compared to 85 to 90 percent for eggs and are the preferred option when a partner is available. The choice depends on relationship status and personal circumstances.
The ideal age for social egg freezing is between 28 and 35 years. Below 35, ovarian reserve is typically good, egg quality is high, and fewer stimulation cycles are needed to freeze an adequate number of eggs. Freezing before 35 provides the most cost-effective and biologically effective preservation. Freezing between 35 and 37 is still beneficial but more eggs may be needed. Above 38, the per-egg live birth probability falls significantly and multiple cycles may be needed.
No. Egg freezing does not deplete your natural egg supply or affect your ability to conceive naturally in the future. Ovarian stimulation retrieves eggs that would otherwise be lost to natural atresia in that cycle. The eggs that are frozen are additional to what your body would have selected naturally. Your ovarian reserve and natural fertility are unchanged by the freezing process.
Vitrified eggs, embryos, and sperm can be stored indefinitely in liquid nitrogen at minus 196 degrees Celsius with no deterioration in quality. Clinical pregnancies have been reported from eggs and embryos stored for over 10 years. Annual storage fees apply. The legal duration of storage and conditions for use are governed by ICMR guidelines in India. Your Samarth IVF team will advise on storage duration and renewal requirements.
Yes, and this is strongly recommended. Egg or embryo freezing before chemotherapy or radiotherapy is the most important step you can take to protect your future fertility. At Samarth IVF, onco-fertility cases are prioritised and we work closely with oncologists to complete a stimulation and freezing cycle within the treatment window. For most solid tumour types, a 2-week delay for egg freezing does not compromise cancer outcomes. Contact us as early as possible after your cancer diagnosis.
The number of eggs recommended depends on age and future family plans. For a woman under 35 wanting one child, 10 to 15 mature vitrified eggs provide a reasonable cumulative probability of success. For two children, 20 to 25 eggs are recommended. Women aged 35 to 37 need 15 to 20 eggs per intended child. Above 38, 25 or more eggs per intended child may be needed and multiple stimulation cycles are often required. Your Samarth IVF specialist will provide a personalised recommendation.
Sperm production often recovers after chemotherapy or radiotherapy, but recovery is not guaranteed, takes 1 to 2 years, and may be incomplete or of reduced quality. Freezing sperm before treatment is strongly recommended as it provides a certain, quality-preserved sample that does not depend on recovery. Multiple vials are frozen to provide for several future treatment attempts if needed.
Egg freezing, embryo freezing, and sperm freezing are available at all Samarth IVF main centres with complete vitrification and cryobank facilities. Ovarian tissue cryopreservation requiring laparoscopic surgery is performed at centres with full surgical infrastructure. Urgent onco-fertility cases are prioritised. Patients at all 14 Samarth IVF centres across India can be referred to the nearest fully equipped centre for fertility preservation with complete care coordination.
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