Breast or breast cancer has currently become the most common malignant tumor in women. It is estimated that a quarter (25%) is diagnosed in young women and is also detected in earlier stages, resulting in less aggressive treatments with more chances of cure.

We see more and more frequently how our center young women come to our center at an early stage of their reproductive age with breast cancer, concerned about the effects of the treatment of this cancer on their ovaries and consequently about their fertility future.

I want to tell all the women with breast cancer that they have not yet had children and want to have them once they are cured of their illness, that today we can offer them real possibilities so that their dream can be fulfilled… a healthy baby and a mother in their home…

The pioneering institutional multidisciplinary program in the preservation of fertility in our country is that of Reprotec Fertility Center that has the guarantees offered by the University Hospital of the Fundación Santa Fe de Bogotá.

We have the greatest experience and are aware of the responsibility that the commitment to preserve fertility for women and even girls implies, since this is in the medium and long term.
Fertility preservation is not an issue that can be addressed in places that do not offer the guarantees of durability over time!

Breast cancer treatment is usually practiced by specialists in breast surgery and oncology, for whom patients must request to be sent to the fertility centers to receive specialized counseling on their alternatives to preserve their fertility for the future. This should ideally be done before starting treatment for your cancer.

Some breast cancer treatments involve the administration of chemotherapy agents that can be toxic to the ovaries and seriously affect both the reserve of eggs, not only in their quantity but, in their quality, as the ability of the cells of the ovaries to produce female hormones. This is why we insist that it is ideal Being able to store the eggs before starting treatments can affect the ovaries.

For four years, the clinical use of egg freezing was approved as a very effective tool that offers real possibilities of having a baby in the future. The technique is known as ¨Egg Vitrification” and is available at our fertility center since its inception.

Fertility treatments to obtain the greatest possible number of eggs have progressed enormously in recent years and it is not necessary to wait for certain times of the woman’s menstrual cycle to be able to start them. In this way, medical oncologists can be given some peace of mind, in which The start of cancer treatment will not be significantly delayed and in this way it will not affect its effectiveness.

The treatment to obtain the eggs consists of stimulating the ovaries with hormone drugs identical to the hormones that women produce in their natural conditions in their pituitary gland to ovulate each month. These are called FSH and LH. This stimulation has an average duration of ten to twelve days and is administered simultaneously with drugs such as letrozole that prevent estrogens from elevating too much so as not to affect the cancer cells of the breast.

During this period of 10 – 12 days, the patient is monitored with ultrasounds and hormonal measurements in her blood to be able to determine when it is the most propitious moment for the extraction of her eggs, which is done by means of transvaginal ultrasound under the effects of a sedation or anesthesia so that the discomfort is minimal or no. Once a satisfactory number of eggs is collected, cancer treatment can be started immediately.

The eggs obtained with this technique are evaluated by clinical embryologists who are experts in cryobiology. This evaluation consists of establishing their quality and classifying them according to their maturational state. Immediately they are frozen with a technique called vitrification, which takes them very quickly at temperatures as low as – 190 degrees Celsius. In this state of vitrification, the eggs can be kept in our laboratory and bank of gametes indefinitely without affecting their quality, to be used when the patient has been cured of their cancer.

At that time they are thawed through very simple laboratory procedures, their viability is evaluated and they are fertilized with the sperm of the patient’s partner. During the next three to five days, fertilization and embryonic development are evaluated by embryologists and doctors, to decide the appropriate time to transfer them to the womb.

Ricardo Rueda Saenz, M.D., FRCSC, FACOG
Reprotec Fertility Center
Chief Section Medicine Reperoductive
Department of Gynecology, Obstetrics and
human reproduction
Santa Fe Foundation University Hospital of Bogotá