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Women with Cancer Want to Know Options for Fertility Preservation
Young female cancer survivors are concerned about their future fertility and want better information and guidance about fertility preservation options, according to a new study published online the Journal of Cancer Survivorship
Today, many more adolescents and young people are surviving cancer, and these young, female cancer survivors are less likely to have biological children because of the effects of the cancer treatments. Many fertility doctors and advocates are working to promote awareness of fertility preservation techniques such as egg freezing, an option that has improved dramatically over the last few years due to a faster freezing technique called vitrification. Fertility doctors stimulate a woman’s ovaries to produce eggs with fertility drugs and retrieve them in the same manner as is performed for in vitro fertilization (IVF).
Jessica Gorman and a team of researchers at the University of California, San Diego presented a paper with in-depth information on young survivors' experiences navigating decisions about fertility and parenthood. The paper explored the fertility and parenthood concerns of 22 American female cancer survivors, ages 18 and 34 years and identified several themes:
- While participants expressed hope about having a family, many also felt anxious that they would be unable to have their own children.
- There was frustration with lack of choice or control over fertility: Even though the young women acknowledged that a discussion about fertility at the time of cancer diagnosis would have been overwhelming, they felt strongly that they (or their parents) should have been told about both the impact of treatment on their fertility and the options available before treatment to preserve fertility, such as egg freezing.
- Young survivors want information about their fertility: Several women reported with regret that their doctors had not talked to them about fertility, and they felt that a young woman was old enough to have this discussion anytime after puberty.
- Many were frustrated with the poor coordination of care between their multiple medical providers, including care related to fertility and pregnancy planning. They felt that each practitioner focused on his or her specialist issue, rather than the bigger picture.
- Young women were concerned about cancer diagnosis and related fertility problems both in the early stages of a relationship and in a more stable relationship.
- Participants listed both emotional (worry about their personal health and life expectancy, as well as worry about their potential child's health) and practical (mainly financial) barriers to parenthood.
The researchers concluded: "The diverse group of young cancer survivors in this study identified several common needs and concerns regarding fertility and parenthood. This study illustrates that young survivors could benefit from improved information regarding their fertility and parenthood options throughout survivorship, better coordination of medical care, and support navigating many emotional and practical issues that arise when considering their reproductive and parenthood options."
Recently, experts in reproductive endocrinology, urology and oncology announced the formation of the Alliance for Fertility Preservation, which is designed to help newly diagnosed cancer patients in the United States access information about their options for fertility preservation. The coalition is co-chaired by John Mulhall, M.D., of Memorial Sloan-Kettering Cancer Center (MSKCC), and Zev Rosenwaks, M.D., and Glenn Schattman, M.D., with the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at New York-Presbyterian Hospital/Weill Cornell Medical Center.