Fertility Preservation Cancer
Progress in early detection and treatment of malignancy has led to increasing numbers of cancer survivors who seek to live normal lives. Sadly, many treatments leave men and women infertile, temporarily or permanently. For cancer patients who desire to have children, this can result in the devastating realization that they may never be parents or have more children without surrogacy, and/or donor eggs and sperm. Patients with cancer are greatly concerned about their fertility and its preservation.
Almost 52% of women undergoing cancer treatment said that having children was the most important goal in their lives, and the majority prefer to have biologically related children. Often patients make treatment decisions based on fertility concerns. 30% of women with breast cancer report that infertility concerns influenced their treatment decisions.
Patients should be advised of possible infertility risks before treatment; and referred to reproductive specialists before treatment. Potential threats to fertility must be addressed as early as possible to permit the widest array of fertility preservation options.
Women
Options for the woman who desires to freeze her eggs before cancer treatment depend on the patient’s age, diagnosis, type of treatment, time available, and the potential that the cancer may metastasize. Age is the most important factor for success. Fertility, egg quality, and quantity dramatically decline after the age of 35. The key to success in the future is to harvest the eggs when the woman is at her peak fertility.
The ovaries can be directly damaged by cancer treatments which can cause premature ovarian failure (when menopause occurs before the age of 40). The uterus can also be damaged, making carrying a pregnancy difficult.
Men
Cancer treatments often pose a threat to male fertility. It may be temporary or permanent infertility. Permanent infertility may result when the cancer treatments kill the sperm stem cells that are the basis for mature sperm, or the testicles are damaged. Genetic damage to sperm DNA is repaired within two years after therapy. For this reason, men are often counseled to wait 2 years before attempting to father a child.
Children
Naturally, the first priority is getting your child lifesaving treatment. 8 out of 10 children survive cancer and most are cured. However, survivors often suffer the late effects of cancer treatments. Late-term health effects of cancer treatment may include impaired fertility. As outcomes have improved, survivors will have improved quality of life when parents seek to preserve their child’s fertility.
Fertility preservation in children is limited to children who are past puberty. This means girls ages 15-17 and boys ages 16-17. Sperm banking is only possible once a boy has gone through puberty. Egg freezing is only possible once a girl has gone through puberty.
Whether and how your child will be affected by treatment in the long term, depends on the type of cancer, type of treatment and dose, location of the cancer, age when treated, general health before the diagnosis, and the child’s genetic makeup.
Late-term effects vary from person to person, so it is important to monitor for problems. Sperm and egg freezing are well-established methods of fertility preservation in children with cancer who are past puberty.
Importantly, fertility preservation does not diminish the chance of successful cancer treatment in most cases, although in some cases it may delay cancer treatment.
At Ohio Reproductive Medicine we understand that a cancer diagnosis is terrifying, and most patients are anxious to start treatment as quickly as possible. We are sensitive to these circumstances and offer immediate appointments (within 1-3 business days) with our reproductive specialists so you can begin preparation for ovarian stimulation quickly. This allows egg harvesting to occur on an accelerated cycle, which decreases time to cancer treatment without compromising egg or embryo yield. Studies show that this “random start” protocol provides similar numbers of eggs retrieved, egg maturation, and fertilization rates similar to conventional start protocols.
Appointments for freezing of semen prior to treatment can be made at Cryobiology, 614-451-4420, weekdays from 7:30 am to 4:00 pm. Obtaining eggs or embryos prior to cancer therapy requires more work. Call Ohio Reproductive Medicine weekdays from 8:00 am to 4:00 pm for very fast appointments, usually within 1 to 3 working days. Often there is some insurance coverage for fertility preservation, and our staff will help you understand your policy benefits that day.
If taking oral contraceptives, we would prefer you stay on them until your first visit to Ohio Reproductive Medicine. Medications to stimulate multiple eggs will require 2 to 3 weeks of treatment, and then a collection of the eggs is an office procedure using local anesthesia. After the collection of the eggs, you can return to your oncologist for therapy.
All patients of reproductive age should receive counseling about their reproductive outlook before cancer treatments, and be offered the option to freeze their eggs, sperm, or embryos, before treatment.
Cryobiology and Ohio Reproductive Medicine are here to help patients preserve their fertility so they can return to normal living after successful cancer treatment, and preserve their opportunity to be biological parents in the future.
Learn More about Ohio Reproductive Medicine
If you would like to find out more information about Ohio Reproductive Medicine, please do not hesitate to contact our fertility expert team. We will answer all of your questions about fertility preservation and help you to decide if this is the right treatment for you.
Fertility preservation offers countless patients the peace of mind of being able to have a family at the right time. To learn more about fertility preservation and your options, please contact our Ohio Reproductive Medicine team today.