Patient Procedures

Ovarian (Egg Cryopreservation, Ovarian Tissue Cryopreservation)

Egg Cryopreservation (Freezing)

This option is available to post-pubertal teens. The female is given hormones in order to stimulate her ovaries to encourage them to develop many large oocytes (immature eggs). Once the oocytes grow, they are then harvested, matured into eggs and frozen for future use, otherwise known as egg cryopreservation (freezing). This technique is an established therapy that has been used for decades and our staff is experienced in providing this care to young females. We approach fertility preservation with sensitivity and attention to the child’s level of development.

If the patient is undergoing cancer treatment and wishes to pursue this option, it requires time prior to treatment in order to complete the stimulation and harvesting process.

What to Expect Before, During and After Egg Cryopreservation

After a discussion with an advanced practice registered nurse (APRN), the patient will be referred to Northwestern Medicine Fertility and Reproductive Medicine for an initial consultation. If the decision to proceed is made, a return visit with our multidisciplinary team will be scheduled prior to starting the hormone treatment.

The process of ovarian stimulation with hormones requires daily lab draws and transvaginal ultrasounds starting on day eight of the process. When large follicles (containing growing oocytes and support cells) are visualized, the harvest will take place under conscious sedation. Usually, patients are able to go home the day of the procedure.

Patients can expect to feel bloated while the ovaries grow follicles. Weight gain of five to six pounds is not unusual. Feeling emotional due to hormone changes is common, but it should be gone within two weeks after the oocyte retrieval. Eggs will remain frozen until the patient wishes to use them. While insurance may cover the surgery cost, processing and storage fees are the responsibility of the patient/parents.

Ovarian Tissue Cryopreservation (OTC)

Our program offers the innovative option of ovarian tissue cryopreservation (freezing) to pediatric patients who may be starting aggressive treatments such as chemotherapy and radiation.

Through laparoscopic surgery, one ovary is removed in order to be cryopreserved (frozen). When the patient is ready to have children, the ovary can be implanted back into the body or the oocytes (immature eggs) in the ovary can be matured into eggs and fertilized for pregnancy. This technique is still considered experimental, so pregnancy cannot be guaranteed. However, there have been over 300 live births from transplantation of this tissue back into the body.

What to Expect Before, During and After Ovarian Tissue Cryopreservation (OTC)

After a consultation with our program provider and the decision is made to proceed with OTC, a date will be determined between the surgeon and primary provider.

Required laboratory tests for infectious disease and hormones will be drawn when the patient is in the operating room. Surgery will be done under general anesthesia. In the event that another surgical procedure needs to be done as well, the OTC is often done at the same time, which limits anesthesia exposure. One ovary is removed by making three small incisions in the abdomen, one in the belly button and one on each side. These incisions will have dissolvable sutures under the skin, which are not visible.

Typically, patients are discharged the same day of surgery after an observation period. Pain can be managed well with acetaminophen and ibuprofen. It is very rare that a patient will need narcotics afterwards. We recommend avoiding contact sports and heavy lifting for 2 weeks following surgery.

After the procedure, the ovary that was removed will be processed and the tissue is shipped to a long-term storage facility. It remains there until the patient decides if and when to use it. While insurance may cover the surgery cost, processing and storage fees are the responsibility of the patient/parents.

Testicular (Sperm Cryopreservation, Testicular Sperm Extraction & Testicular Tissue Cryopreservation)

Sperm Cryopreservation (Freezing)

Sperm cryopreservation is an option for post-pubertal males. The patient provides a semen sample and sperm is isolated for cryopreservation (freezing). This technique is an established therapy that has been used for decades and our staff is experienced in providing this care to young males. We approach fertility preservation with sensitivity and attention to the child’s level of development.

If the patient requires any type of chemotherapy, it is best to collect sperm sample(s) prior to the start of their treatment.

What to Expect Before, During and After Sperm Cryopreservation

After a discussion with an advanced practice registered nurse (APRN), the patient will be referred to Northwestern Medicine Urology for an initial consultation and to schedule lab appointments.

The patient will provide a semen sample, and after the first sample, a semen analysis is done before it is cryopreserved (frozen). Depending on these results, he may be required to come back to the lab to provide additional samples, if needed, as it is recommended that five to ten vials are cryopreserved.

Insurance does not usually cover the costs for visit. Processing and storage fees are the responsibility of the patient/parents.

Testicular Sperm Extraction (TESE)

TESE is available for post-pubertal males in the event that sperm banking does not yield any sperm. It is a surgical procedure to obtain testicular tissue and extract spermatozoa (non-motile sperm) from the tissue to cryopreserve (freeze) them for future use.

What to Expect Before, During and After Testicular Sperm Extraction (TESE)

After a consultation with our program provider and the decision to proceed with TESE is decided, a date will be determined between the surgeon and primary provider.

Required laboratory tests for infectious disease and hormones will be drawn when the patient is in the operating room. The patient will be under conscious sedation. Generally, one testicle is exposed through a small incision in the scrotum. These incisions will have dissolvable sutures under the skin, which are not visible. 

During the procedure, the small sections of testis tubules, which contain immature sperm cells and spermatozoa (non-motile sperm) are removed. Spermatozoa are identified, processed for cryopreservation (freezing), and shipped to a long-term storage facility. They remain there until the patient decides if and when to use them. While insurance may cover the surgery cost, processing and storage fees are the responsibility of the patient/parents.

Testicular Tissue Cryopreservation (TTC)

Testicular tissue cryopreservation (freezing) is an innovative option for pre-pubertal males who are not yet producing mature sperm. In this case, a surgeon removes a portion of the testicle tissue, which is then frozen for the patient’s future use. This technique is considered experimental. Research is being conducted in collaboration with the University of Pittsburg.

What to Expect Before, During and After Testicular Tissue Cryopreservation (TTC)

After a consultation with our program provider and the decision to proceed with TTC is decided, a date will be determined between the surgeon and primary provider.

Required laboratory tests for Infectious disease and hormones will be drawn when the patient is in the operating room. He will be put under general anesthesia. In the event that another procedure needs to be done as well, the TTC is often done at the same time, which limits anesthesia exposure. A small incision will be made in the scrotum in order to take a small piece of tissue out of the testicle. The incision will have dissolvable sutures under the skin, which are not visible. Liquid glue will be painted over the incision area, so it does not require a bandage. The liquid glue will wear off on its own in five to ten days.

Typically, patients are discharged the same day as the procedure after an observation period. Pain can be managed extremely well with acetaminophen and ibuprofen. It is very rare that a patient will need narcotics afterwards.

After the procedure, the tissue that was removed will be processed and shipped to a long-term storage facility, where it remains until the patient decides if and when to use it. While insurance may cover the surgery cost, processing and storage fees are the responsibility of the patient/parents.

Gonadal (Gonadal Tissue Cryopreservation)

Gonadal Tissue Cryopreservation (GTC)

Gonadal tissue cryopreservation (freezing) may be an option for patients with differences of sex development (DSD), where the decision is made between the patient/parent and their primary physician to have a gonadectomy, which is an operation to remove gonadal tissue. Individuals with DSD may have infertility caused by abnormal gonadal development or have previously had a gonadectomy performed for risk of malignancy.

What to Expect Before, During and After Gonadal Tissue Cryopreservation (GTC)

If the decision to have a gonadectomy is made, an advanced practice registered nurse (APRN) is notified to counsel the family on preserving the tissue for potential future use.

Laparoscopic surgery is performed by the patient’s primary surgical team. The patient will be under general anesthesia and three small incisions will be made in the abdomen, one in the belly button and one on each side. These incisions will have dissolvable sutures under the skin, so they are not visible. Surgical tape will be applied on the skin over the incisions.

Typically, patients are discharged the same day as the procedure after an observation period. Pain can be managed well with acetaminophen and ibuprofen. It is very rare that a patient will need narcotics afterwards. A follow up appointment with the primary surgeon is scheduled a few weeks after surgery to review the pathology results and to discuss whether the tissue removed will be stored for potential future use.

If the tissue is going to be stored, it is processed and shipped to long-term storage facility, where it remains until the patient decides if and when to use it. While insurance may cover the surgery cost, processing and storage fees are the responsibility of the patient/parents.