• What this is – no methods are used to try and preserve fertility.
• When this is used – when you don’t have time to consider fertility preservation and choose to start cancer treatment immediately.
• How this works – no action.
• Considerations – more likely to lead to premature ovarian insufficiency.
• Pregnancy rate – depends on age and cancer treatment.

• What this is – collecting, developing and freezing eggs or embryos as part of an in-vitro fertilisation (IVF) cycle.
• When this is used – when you want to store eggs or embryos for use in the future, the frozen egg will be fertilised using IVF, or the embryo will be implanted in your uterus. 
• How this works – egg and embryo freezing is part of IVF – the most common and successful assisted reproductive technology for preserving female fertility. One cycle of IVF can take 2–3 weeks. Egg collection is done in an operating theatre as a day procedure.
• Considerations – you can only freeze eggs or embryos before cancer treatment if you have time – your cancer specialists will advise how quickly cancer treatment should begin. Talk with your fertility specialist about whether to freeze eggs, embryos or a mix of both. Ask the fertility clinic about the cost of storing eggs and embryos and any legal limits on how long they can be stored (different in each state). Sperm from a partner or donor sperm is needed to create an embryo. To use a frozen embryo, you will need consent from the sperm donor. Legal documents outlining instructions if a relationship breaks down are required for male donors with a partner.
• Pregnancy rate – freezing eggs works nearly as well as freezing embryos. For every 10 eggs frozen, you can expect to get 1–4 embryos. Depending on your age, the success rate of the fertility clinic and the stage at which the embryos are stored, there may be a 25–40% chance per cycle of a frozen embryo developing into a pregnancy.

• What this is – the process of removing, slicing, freezing and storing tiny pieces of tissue from an ovary so it can be used later. 
• When this is used – if treatment needs to start immediately, if taking hormones to encourage egg production is unsafe, if there is a high risk of infertility, or if the person hasn’t gone through puberty. It can be used in addition to egg freezing.
• How this works – tissue is removed from your ovaries during keyhole surgery (laparoscopy); if you have abdominal surgery as part of cancer treatment, tissue can be removed at this time. Tissue is frozen until it is needed. When needed, the tissue is thawed and put back (grafted) into the ovary. Tissue may produce hormones and eggs may develop.
• Considerations – tissue stored before treatment has a risk of containing cancer cells, and you may not want to put this tissue back into your body; risk is higher for people with leukaemia. Legal limits on how long ovarian tissue can be stored are different in each state and territory. Ask your fertility clinic how much you will have to pay for storage
• Pregnancy rate – there have been a small number of births worldwide from ovarian tissue removed before puberty, and several births from ovarian tissue removed after puberty. About 1 in 3 people who have tried to use ovarian tissue to become pregnant have been successful.

• What this is – surgery that moves one or both ovaries to prevent damage to the ovaries during radiation therapy.
• When this is used – when one or both ovaries are in the path of radiation therapy. Limits how much radiation the ovaries receive.
• How this works – one or both ovaries are moved away from the field of radiation and stitched in place. They are put back in place after radiation therapy ends.
• Considerations – procedure may cut off blood supply, causing damage to the ovaries.
• Pregnancy rate – depends on your age, the amount of radiation that reaches the ovaries and whether you start menstruating again.

• What this is – trachelectomy removes part or all of the cervix and keeps the uterus, fallopian tubes and ovaries in place. An unilateral-salpingo oophorectomy removes only one ovary.
• When this is used – trachelectomy is used for small tumours found only in the cervix. An unilateral salpingooophorectomy is for earlystage cancer found only in one ovary.
• How this works – the uterus is stitched tight with a small opening to allow blood to pass out during a period and for sperm to enter.
• Considerations – risk of miscarriage and premature birth; may have a stitch placed in what remains of the cervix to reduce the risk.
• Pregnancy rate – number of births after this procedure is increasing.

• What this is – gonadotropin-releasing hormone (GnRH) analogue is a long-acting hormone that stops the ovaries making oestrogen for a short time. It may protect eggs from being damaged.
• When this is used – at least one week before chemotherapy starts, continuing until chemotherapy finishes.
• How this works – hormone injections given 7–10 days before chemotherapy starts or during the first week of treatment, then every month or every three months during chemotherapy.
• Considerations – backup to other fertility preservation options . Can affect bone density if used for more than six months.
• Pregnancy rate – studies show that treatment is suitable for young women with breast cancer but there is no evidence for other types of cancer. 

In most cases, eggs are donated by a family member or friend. Your fertility clinic may have an egg bank, but there is usually a long waiting list.

All donors are required to have blood tests for infectious and genetic screening, answer questions about their genetic and medical information, and have counselling.

After the eggs are collected from the donor, they are combined with sperm from your partner or a donor using IVF.

Donor embryos usually come from people who still have frozen embryos after they’ve had successful IVF treatment. Embryos may be donated for ethical reasons (instead of discarding the embryos) or compassionate reasons (to help someone with infertility).

If you use a donated embryo, you will have counselling to answer all your questions and plan ahead. It’s also a good idea to seek legal advice before proceeding. When you are ready, you will take hormones to prepare your uterus for pregnancy.

When your body is ready, the embryo will be thawed and implanted into your uterus using IVF. A child born from a donated embryo is deemed to be the child of the birth mother. Donors have no legal or financial obligation to the child.