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Fertility and Cancer: Understanding Your Options

This year, there will be an estimated 1.6 million Americans diagnosed with cancer.(1)  Although serious, this diagnosis no longer carries the bleak prognosis as before, due to recent treatment advances dramatically improving survival. Optimization of the quality of life for patients after cancer treatment has become a growing priority. For many cancer survivors, this may mean the ability to have or expand a family. Being educated about the impact of cancer treatment on one’s fertility and the available options to preserve fertility can be empowering and provide a sense of control over one’s future quality of life.

Talking to Your Physician

If you have been diagnosed with cancer and are considering a treatment plan, it is imperative that you discuss your fertility options with your healthcare team as soon as possible. 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.(2) 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.(3) Some questions you might ask include:

  • How will the treatment plan impact my fertility?
  • Are there alternative treatments that could be less toxic to my reproductive health?
  • What fertility preservation options are available to me?

How Cancer Treatments Impact Fertility

It is important to assess the impact of your individualized cancer treatment plan on your future reproductive capacity. There are several factors that can influence the degree of fertility impairment.

  • Type of cancer and cancer treatment. Location, stage and type of cancer determine the treatment plan. The degree of fertility loss post-treatment is strongly influenced by the total amount of radiation exposure, dose and type of chemotherapeutic agent used, and surgical procedures involving the reproductive system.(4)
  • Age at time of treatment. The risk of irreversible damage 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.(5)  

Fertility Preservation Options

There are many well-established and emerging procedures available for fertility preservation. For women, some options that have proven to be successful include:(6)

  • 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 transposition. An outpatient surgical procedure where the ovaries are repositioned outside the planned radiation field during treatment. 
  • Trachelectomy. Partial surgical removal of the cervix to treat early-stage cervical cancer thus avoiding a complete hysterectomy and loss of reproductive function.

Options for fertility preservation for men include:(7) 

  • 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.

It is important to note that these are just some of the treatments available to you. Your reproductive specialist will work closely with your oncologist to tailor your fertility preservation plan with your cancer treatment plan as to optimize 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. Resources you might consider include:

(1)“Cancer Facts & Figures 2013.” American Cancer Society.” 2013. Web. http://www.cancer.org/research/cancerfactsfigures/cancerfactsfigures/cancer-facts-figures-2013.
(2)“What Cancer Patients Should Know About Fertility,” Fertility Authority. March 2013. Web, http://www.fertilityauthority.com/articles/what-cancer-patients-should-know-about-fertility.
(3)“What Cancer Patients Should Know About Fertility,” Fertility Authority. March 2013. Web, http://www.fertilityauthority.com/articles/what-cancer-patients-should-know-about-fertility.
(4)“Fertility and Cancer.” American Cancer Society. 19 November 2012. Web. http://www.cancer.org/treatment/treatmentsandsideeffects/index.
(5)“Fertility and Cancer.” American Cancer Society. 19 November 2012. Web. http://www.cancer.org/treatment/treatmentsandsideeffects/index.
(6)“Fertility and Cancer.” American Cancer Society. 19 November 2012. Web. http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/sexualsideeffectsinwomen/fertilityandwomenwithcancer/index.
(7)“Fertility and Cancer.” American Cancer Society. 19 November 2012. Web. http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/sexualsideeffectsinmen/fertilityandmenwithcancer/index.