Cancer treatments and fertility, having a family after cancer
More and more patients seeking infertility treatment at TFC have been recently diagnosed with cancer or other chronic diseases. When they come to see us, they want to understand the available options that will hopefully allow them to preserve their fertility. In the past, all we could do for these patients was bank sperm or embryos and hope that a few would survive their cancer long enough to return for a chance for pregnancy.
As a result of significant advances in cancer treatment, however, more and more patients are surviving their cancers and they are therefore very interested in subsequent fertility. After winning their battle against their disease, they understandably have high expectations for a successful outcome. Fortunately, there have been many recent advances in egg, sperm and embryo freezing that allow us to offer these patients significant hope for achieving a family of their own.
Fertility threatening treatments, whether for cancer or other types of chronic disease such as rheumatoid arthritis or others, primarily include chemotherapy, radiation therapy and surgery. Factors to consider when trying to determine the best alternatives and approaches for fertility preservation include the age of the patient, the site of treatment, and the types of medication or other therapy that will be administered to treat the underlying disease.
Cancer treatments that can affect male and female fertility
There are many different types of chemotherapeutic protocols and medications that are widely used today. Some medications are well known to have a profound adverse effect on subsequent fertility, whereas others are much more mild. The chemotherapeutic agents that appear to have the most severe adverse effects on fertility include drugs such as cytoxan, cisplatin, and procarbazine, whereas medications such as methotrexate or 5-flourouracil appear to have a substantially milder effect. Obviously the timing of your therapy, as well as the choice of specific drugs is up to your oncologist. Nevertheless, we will work closely with your other physicians to allow you to cryopreserve as many gametes as possible without interfering with your chemotherapeutic plan.
The effects of ionizing radiation on fertility can also vary markedly – depending primarily on the dose administered and the site(s) being treated. While effective gonadal shielding may serve to limit total radiation exposure, there are other options available to patients as well. As survival rates have improved, the radiation oncologists have become much more sensitive to fertility preservation. They will, therefore, thoroughly discuss your options with you prior to the initiation of treatment.
Fertile Hope is a national LIVESTRONG initiative dedicated to providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility. This organization provides information on types of Cancer treatments and their affects on future fertility
Surgical treatment may involve resection or removal of the ovaries or the testicles, as well as other parts of the reproductive anatomy. Adjunctive treatment with either chemotherapy or radiation therapy is frequently given either before or after surgical resection. Advance planning, through inclusion of your TFC physician in the treatment process, can serve to maximize your opportunity for fertility preservation.
Discussing Medical Fertility Preservation for Oncofertility With Dr. Amy Schutt