Cancer treatment can interfere with fertility in many ways, because the same medicines and treatments that work to kill cancer cells also affect other cells, organs and hormones in the body. The likelihood that cancer treatment will harm your fertility depends on several factors, including the type of cancer, type of cancer treatment and your age at the time of treatment. The effects of chemotherapy and radiation therapy also depend on the type of drug or the size and location of the radiation field. The most severe damage is caused when radiation is applied to the ovaries or testicles and by chemotherapy drugs called alkylating agents.
Since every patient is different, there is no way to predict whether your cancer treatments will cause infertility. Fertility can be affected by a single cancer therapy session and those effects can be temporary or permanent.
At the Fertility Institute, we understand a diagnosis of cancer can be overwhelming and we want to help you consider all options regarding fertility preservation before you begin treatments. Our doctors will consider the type of cancer you have, your treatment plan and the amount of time you have before starting treatments, before determining the best option for you and your family.
FERTILITY PRESERVATION FOR WOMEN
Female fertility can be compromised by cancer treatments that involve the surgical removal of the uterus or ovaries. A woman’s eggs, hormone levels, or the functioning of her ovaries, uterus or cervix may also be affected by cancer treatments. There is a chance of developing premature menopause after cancer treatments and, for older woman, a possibility of permanent ovarian damage.
For woman about to undergo cancer treatments, there are various fertility preservation options:
Embryo cryopreservation: In this procedure, eggs are harvested from a woman’s ovaries, fertilized through in vitro fertilization (IVF), frozen and stored. At the beginning of a woman’s menstrual cycle, she will be given daily injections of synthetic hormones in order to stimulate her ovaries. This is to increase the likelihood that multiple eggs can be collected during a cycle. Mature eggs are then removed, combined with sperm, and then frozen. Timing ovarian stimulation may delay the start of cancer treatments by a few weeks, however research suggests that this method for fertility preservation has the highest success rate.
Embryo Freezing: A woman’s eggs are removed and fertilized by the sperm of her partner or donor within a test tube. The resulting embryos are then frozen and stored for in vitro fertilization.
Gonadal shielding: Carefully placed shields reduce the exposure of radiation to a woman’s reproductive organs.
Ovarian transposition: During this procedure, a woman’s ovaries are surgically repositioned just before radiation therapy so they’re as far away as possible from the planned radiation field.
Radical trachelectomy: If a woman has early-stage cervical cancer, this procedure, which involves the surgical removal of the cervix, can help preserve fertility.
FERTILITY PRESERVATION FOR MEN
Male fertility can be harmed by the surgical removal of the testicles or by chemotherapy or radiation that damages sperm quantity, quality or its DNA. Men can also take the following steps to preserve their fertility before undergoing cancer treatment:
Sperm cryopreservation: Before cancer treatment begins, a sample of the Male’s semen is collected, frozen and stored. Sperm must be banked before any chemotherapy or pelvic radiation therapy begins in order to avoid storing damaged sperm. The sperm can be thawed later and used for intrauterine insemination or in vitro fertilization.
Gonadal shielding: By carefully placing shields over the man’s testicles, it reduces their exposure to radiation.