A cancer diagnosis can be devastating for your physical and mental health. Cancer treatments are likely to affect the fertility of those with the disease, especially for women. However, with improved technology and treatment options like chemotherapy and radiation therapy, most people diagnosed with cancer will survive and thrive. According to Livestrong, the survival rate for all cancer patients under 45 is about 80%. For more common cancers, such as breast cancer, the survival rate is 90% according to the American Cancer Society. And if you have cancer diagnosis at an early stage the survival rate increases to 99%. Let’s see why cancer patients should consider fertility preservation before treatment. What are the options and resources available to them as they consider their options.
Medical treatments for a cancer patient should have more priority. That means they should look past their immediate medical needs and focus on how their future might be impacted by the treatment decisions they make. Hence, they should not only try to preserve their lives, but also the quality of life.
Cancer Treatments Can Compromise Fertility!
Many necessary cancer treatments can put your fertility at risk. Although it is possible to take precautions and remedies to preserve your fertility before life-saving cancer treatments. According to a research study, 40 – 80% of women of reproductive age are at a risk of infertility from cancer treatments. Approximately 30-75% of men are also at risk for infertility.
Surgery
The best course of treatment for people with cancers of the reproductive system is to remove the affected ovary, uterus, fallopian tubes, or prostate. It is obvious that the removal of such crucial parts of the reproductive system can make it impossible for someone to get pregnant on their own. Additionally, even if the surgery to remove a tumor does not remove whole organ, it can cause scarring. This can affect ovulation or the ability to get pregnant and carry a pregnancy. If this is the only treatment option and patients want to have children in the future, they must consider fertility preservation before surgery.
Chemotherapy
Chemotherapy uses medications called cytotoxins and cytostatics to kill cancer cells and prevent them from dividing and spreading. But the administration of these medications occurs through the bloodstream. As the blood runs throughout into the entire body, these medications affects other cells as well.
A woman is born with all the eggs they’ll ever have. During chemotherapy, all her eggs can be damaged by chemotherapy drugs. Even the slightest damage to the egg’s DNA will not allow it to fertilize (the egg becomes genetically abnormal) or may result in miscarriages or birth defects.
Men are also at risk of becoming infertile during chemotherapy. While men’s bodies do produce sperm throughout their adult lives, chemotherapy can still have a negative effect. High doses can decrease sperm cell production and possibly affect the testicles’ ability to make testosterone, which is a critical fertility hormone.
Radiation therapy
Radiation therapy involves emitting high-energy rays directly at the cancer cells, in hopes of killing them. But this treatment also damages body parts surrounding the cancer as well. Radiation therapy can destroy some or all of a woman’s eggs. It can cause scarring in her uterus, cervix, or fallopian tubes.
Those with cancer in the abdominal or pelvic areas are most at risk of infertility from radiation therapy. Since ovulation begins in the brain with pituitary gland, radiation in that area can affect fertility as well. It’s a fact that this treatment is likely to destroy eggs which means a female cancer survivor may go into menopause earlier. Some men may also experience a temporary drop in fertility after radiation, which can recover in the years after treatment. Some may need a higher dose of treatment, which can permanently stop sperm production.
All these reasons make fertility preservation a viable option for cancer patients.
Better Information
Unfortunately, many cancer patients do not receive enough information about their fertility preservation options before treatment starts. You should talk to your doctor and understand how your cancer treatment will affect your future fertility. Also, ask them if you should preserve your fertility.
With oncofertility, you can preserve the hope of becoming a parent in the future.
Ask your doctor if your treatment plan includes procedures that might put your fertility at risk. If it is so, then ask them to refer you to a fertility preservation specialist so you can access all your available options.
Fertility Preservation Options
There are several standard fertility preservation options available. Let’s have a look at the most common of them.
Egg Freezing
Egg freezing is one of the very convenient fertility preservation option for women who are to undergo cancer treatment. In this procedure, the ovaries undergo stimulation after injecting hormone medication. It helps to prompt the production of multiple eggs in one maturation cycle, instead of a single egg. After they mature, retrieval of all the eggs take place in an outpatient surgical procedure. During this retrieval process, the patient is under a mild sedative. The doctor uses a needle, passes it through the vaginal wall and collects eggs directly from the ovaries.
The retrieved eggs are then brought to a laboratory. Here they go into cryopreservation via a technique called vitrification. After that the frozen eggs are stored in liquid nitrogen at -196℃ until the woman decides to use them.
Egg freezing is mostly chosen by single women and women who want options when it comes to how, and with whom she will use their eggs down the road.
Embryo Freezing
This process follows the same procedures as egg freezing, up until the egg retrieval part. After the eggs retrieval, they are immediate fertilization with the sperm of a partner or donor takes place. These fertilized eggs then develop into a healthy embryo over the next 5 days under the careful eye of an embryologist. Finally, the healthy embryos are frozen and stored to prevent any biological activity.
The difference in IVF success rates between egg freezing and embryo freezing is negligible. The only difference is that with embryo freezing you’ll know upfront how many genetically healthy eggs you’re working with.
Married women, who know for sure that they’ll want children with a specific known person in the future, mostly choose embryo freezing. Coastal Fertility of Orange County offers advanced embryo freezing before cancer treatment or for any other reason.
Ovarian Suppression
In this procedure, injectable medications are used to shut down ovaries temporarily before chemotherapy. The actual success rates of ovarian suppression are still not clear. So, oncofertility experts recommend pairing it with more effective options like egg or embryo freezing.
Sperm Freezing
There may not be as many fertility preservation options for men going for cancer treatment, but it’s much simpler. The most common procedure is sperm freezing, which requires no medication. At a local fertility clinic or cryobank, they leave a semen sample. The sample is analysed, washed, frozen and stored until needed. Multiple samples are usually frozen to ensure a good chance of pregnancy later.
Some Less Common Options
Ovarian Transposition
In this procedure, the ovaries are moved higher up in the abdomen. This prevents the harm of radiation. Only the women, who are undergoing radiation treatment can use this process. They will have no protection against the effects of chemotherapy.
Ovarian Tissue Freezing
This is a much less preferred option. During this procedure removal and freezing of a whole or partial ovary including immature eggs take place. Later on, after the successful cancer treatment, ovarian tissue is re-implanted into the body. This procedure is still in an experimental phase. Although it does offer a fertility preservation option to women who don’t want to undergo egg or embryo freezing.
Cancer patients who undergo fertility preservation before cancer treatment have multiple family building options later. Although, how long you need to wait to get pregnant after your cancer treatment is a different aspect altogether. It depends on the type of cancer and cancer treatment that you chose. Your doctor can provide more information as to when you can safely get pregnant. The good news is that the shelf life of frozen embryos, eggs and sperm is quite extensive. This way you can concentrate on getting healthy and then start a family when you’re ready to do so.
Coastal Fertility is a fertility clinic in Orange County, California. We have helped thousands of patients start the family of their dreams. For more information you can visit us at www.coastalfertility.com or call (949) 726-0600.
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