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Summer 2006 – Before a female cancer patient can postpone therapy to do an IVF cycle, she must have clearance from her oncologist that she is medically stable. If it is critical for her to start therapy, as it often is in leukemia patients, IVF may not be an option.

To begin, the woman takes daily shots of a medication containing follicle-stimulating hormone (FSH), which promotes egg growth. In breast cancer patients, FSH poses a problem because it causes estrogen levels to rise, and estrogen will fuel the tumor. Washington University has a new study in which these women also take aromatase inhibitors that prevent estrogen levels from mounting.

Through blood work and ultrasounds, the center staff monitors the growth and size of the eggs, modifying the doses of medicine as necessary and completing the process with a medication that triggers the eggs to finish maturing. Thirty-six hours later, the patient comes to the procedure room, where she is sedated. The physician inserts a small needle through her vagina into the fluid- filled spaces of her ovary. This follicular fluid then goes to a waiting embryologist, who searches through it under a microscope to locate viable eggs.

Meanwhile, her male partner provides a sperm sample, which the staff uses to inseminate the eggs. The next morning, they come back to see whether the eggs have been fertilized successfully. If so, they are frozen. When the patient is cleared by her oncologist, they thaw the embryos and place them in her uterine cavity using a small catheter – two or three at a time. Nine months later, with a little luck, the procedure has a happy outcome.