Fertility Preservation Options for Cancer Survivors
September 2019
By Dr. Charu Jandial
Diagnosis of cancer can be a life crisis for any person. Its impact varies with the type of cancer, treatment prospects and physical, emotional and social sources of the patient. Improvements in cancer treatment have enabled young persons with cancer to survive. A younger person faces the additional potential loss of reproductive function and the opportunity to have children.
How can cancer treatment affect fertility?
The harmful effects of cancer therapy fertility can be temporary or permanent. Cancer treatment and their effects might include :
1. Surgery: Fertility can be affected by the surgical removal of uterus, ovaries and testis.
2. Chemotherapy: Maximum damage is done by drugs called alkylating agents. Younger women who receive chemotherapy are less likely to become infertile than older women.
3. Radiation: Radiotherapy can be more damaging than chemotherapy depending on the location and size of the radiation field and the dose given.High doses of radiation can destroy some or all of the eggs in the ovaries.
Other are hormones therapies for breast cancer. But its effects are often reversible.
Infertility as a result of cancer treatment can be psychologically upsetting for many patients and data suggests that those who pursued fertility preservation usually cope better with their cancer treatment.
When to think about fertility preservation after the diagnosis?
The optional time for considering fertility preservation is before the initiation of any cancer treatment.
When to think about fertility preservation after the diagnosis?
A fertility specialist can help to preserve gametes, embryos and gonadal tissues before the treatment starts. Secondly, they will assist in using cryopreserved gametes and tissues for assisted reproduction.
How can woman preserve fertility before cancer treatment?
Women who are about to undergo cancer treatment have various options when it comes to fertility preservation. For eg:
- Embryo cryopreservation: This procedure involves harvesting eggs, fertilizing them and freezing, so they can be implanted at a later date. Research shows that embryos can survive freezing and thawing process up to 90% of the time.
- Egg Freezing: Patients who are single or do not have a male partner can go for egg freezing.
- Ovarian Transposition: In this procedure, ovaries are surgically repositioned in the pelvis so that they are out of the radiation field. After treatment, ovaries need to be repositioned again to conceive.
- Ovarian Tissue Freezing: Is an experimental option for prepubertal patients.
What can men do to preserve fertility before cancer treatment?
Men can also preserve their fertility before undergoing cancer treatment. For example:
1. Semen cryopreservation.This procedure involves freezing and storing semen at a fertility clinic or sperm bank for use at a later date. Samples are frozen and can be stored for years.
2. Radiation shielding: In this procedure, small lead shields are placed over the testicles to reduce the amount of radiation exposure they receive.
With continued research and clinical progress in this area, fertility preservation can be a safe, affordable and successful option for cancer survivors.