Recent advances in oncology medicine have resulted in a longer lifespan and improved quality of life in millions of patients worldwide. This success has increased awareness of preserving the reproductive potential of our reproductive-aged men and women, in light of chemotherapeutic and radiation treatment regimens that can often result in sterilization.
At North Dallas IVF, we are dedicated to providing highly specialized fertility preservation services to our newly diagnosed and existing cancer patients in a safe and time-sensitive fashion. We take a multi-faceted approach and coordinate care between your hematologist/oncologist and, if applicable, your oncology surgeon as well. We are sensitive to the fertility needs of men and women who are about to undergo or have undergone cancer treatments, and work to preserve the ability to have children whenever possible. We will discuss your fertility options carefully with you to ensure you understand the risks and chances of success.
Preserving Fertility before Cancer Treatment
A number of options exist for preserving your reproductive potential. The most common and successful methods we advise patients on include:
- Cryopreservation: In the case of a female patient, we would perform an expedited IVF cycle (link to IVF page) followed by an egg retrieval (link to Egg Retrieval page) procedure. We are able to freeze the resulting eggs or fertilize them with sperm, then freeze the developing embryos. The cryopreserved eggs or embryos are then frozen for future use. Once your cancer treatment is complete, we would consult with your cancer treatment team to determine the safest interval after which to transfer the embryos back and attempt pregnancy.Sperm cryopreservation can occur anytime after puberty. Here, the man provides several samples of his semen to our andrology (fertility) laboratory. Our standard protocol involves testing the semen sample for the number of sperm cells it contains (sperm count), what percentage of sperm are able to swim (motility) and how many have a normal shape (morphology). The sperm cells are then frozen and stored. In theory, sperm collected before cancer treatment should be just as likely to achieve a pregnancy as sperm collected without the presence of cancer.
- Radiation shielding: During radiation treatment in the woman, an ovarian transposition may be performed to move the ovaries away from the target zone. Surgeons will usually move the ovaries above and to the side of the central pelvic area. This procedure typically does not require being in the hospital, and can be done either before or after puberty.
Chemotherapy and Pregnancy
Female considerations: Many chemotherapy drugs will damage some of the eggs stored in your ovaries. It is hard to predict how many women will stay fertile after chemotherapy. Your age, the types of drugs you receive and drug dose are all important variables in determining the effect on the ovaries. It is best to visit with your fertility physician and oncologist about your desire to remain fertile after chemotherapy, and work towards a solution that will minimize the risk of infertility if at all possible.
Male considerations: Since sperm cells divide quickly, they are an easy target for damage by chemotherapy. The higher the dose of chemotherapy a man receives, the longer it takes for sperm production to get back to normal, and the more likely it is to stop. Permanent infertility results if all the stem cells in the testes are damaged to the point that they can no longer produce maturing sperm cells. The most damage generally occurs when men are treated with both chemo and radiation therapy to the abdomen or pelvis.
The risk of the chemotherapy causing infertility varies depending on the type of drug and the doses used. After chemo treatment, sperm production slows down or may stop altogether. Some sperm production usually returns in one to four years, but can even take up to ten years. Men older than 40 may be less likely to recover their fertility, but age seems to be less of a factor in men than in women.
Weigh Your Options
The effects of cancer treatment on fertility depend on many factors, including the type of cancer, where it is, your age, gender and your response to treatment. If you can, talk with us or your primary doctor before treatment to learn about all of your choices.
If you are facing cancer, the good news is that in most cases you can become a parent if you wish. It may not happen in the way you had expected before you had cancer or had always dreamt about, but there are options — and we can help.
Source: American Cancer Society