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Fertility and Cancer: The Importance of Understanding Your Options
Article sponsored by Ferring Pharmaceuticals Inc.
May 19, 2014
Each year in the U.S., about 70,000 adolescents and young adults (ages 15-39) are diagnosed with cancer. However, recent treatment advances have dramatically increased the survivorship for many types of cancers. This means that cancer patients need not only consider how best to treat their cancer, but also how to optimize their quality of life after treatment. For many cancer survivors, this may mean the ability to have or expand a family. Being educated about the impact of cancer treatment on fertility and understanding the available options to preserve fertility can be empowering and provide a sense of control over one’s future quality of life.
Starting a Conversation with Your Medical Team
If you have been diagnosed with cancer and are considering a treatment plan, it is important to discuss your fertility options with your healthcare team as soon as possible. Fortunately, taking the time to research your options rarely interferes with the efficacy of your cancer treatment, and most reproductive specialists will see cancer patients within one or two days after being referred. Fertility can be damaged even by the first cancer therapy session and most fertility preservation procedures need to be completed prior to starting chemotherapy or radiation. If you’re unsure how to start a conversation with your medical team, some questions you might ask include:
- How will this treatment plan impact my fertility?
- What is fertility preservation and what options are available to me?
- Can you recommend a specialist who can work with us in developing a treatment plan?
- Are there treatments we can consider that will have less of an impact on my future reproductive health?
The Impact of Cancer Treatments on Fertility
Your healthcare team should discuss how your individualized cancer treatment plan could impact your future fertility. There are several factors that can influence the degree of reproductive impairment:
- Cancer type and treatment. Collectively, the location, stage and type of cancer determine the treatment plan. The degree of fertility loss post-treatment is determined by the total amount of radiation exposure, dose and type of chemotherapeutic agent used, as well as surgical procedures involving the reproductive system.
- Age at time of treatment. The risk of irreversible damage to reproductive organs increases with the age of the patient at the time of treatment. Patients under the age of 30 have a greater chance of recovering their fertility post treatment.
Options for Fertility Preservation
There are many well-established and emerging procedures available for fertility preservation. For women, some options that have proven to be successful include:
- Embryo cryopreservation. After 10 to 12 days of fertility medication injections, eggs are harvested from the ovaries during an outpatient surgical procedure, fertilized through in vitro fertilization (IVF), frozen and stored for later use.
- Egg freezing. Similar to embryo cryopreservation, after 10 to 12 days of injections, eggs are harvested and frozen unfertilized.
- Ovarian tissue freezing. Small sections of the ovary are surgically removed, frozen, and then surgically grafted back into the pelvic area after cancer treatment has concluded. Allows for spontaneous conception if successful.
- Ovarian transposition. Ovaries are repositioned outside of the planned radiation field during treatment as part of an outpatient surgical procedure.
- Trachelectomy. Early-stage cervical cancer is treated with partial surgical removal of the cervix, thus avoiding a complete hysterectomy and loss of reproductive function.
Options for fertility preservation for men include:
- Sperm cryopreservation. Collection of multiple semen samples which are subsequently frozen and stored.
- Gonadal shielding. Placing of shields to cover the testicles during cancer treatment thereby reducing the testicles' exposure to radiation.
The treatments listed above are just examples of some of the treatments that may be available to you. It is important to ensure your reproductive specialist is working closely with your oncologist to tailor your fertility preservation plan with your cancer treatment plan, optimizing results for both.
Fertility Preservation Resources
Ask your oncologist or reproductive specialist for resources that can help you access savings programs for both treatment and medication. For example, Ferring Pharmaceutical Inc.’s Heart Beat fertility preservation program (www.heartbeatprogram.com) helps eligible patients pursuing fertility preservation services prior to cancer treatment ease some of the financial burden.
Other resources you might consider include: