Infertility experts say women with cancer should seek fertility preservation

Infertility experts stress that when a woman of childbearing age receives a cancer diagnosis, it’s imperative to research and ask questions about fertility preservation.

Patients need to ask their oncology team about the potential risks of infertility, even if they do not presently want to have a child, or they are unsure about their desire to have a child in the future. They need to be vocal about their desires so they are able to make an active rather than a passive decision about their future fertility. There are established treatments for preserving fertility and seeking a fertility specialist as soon as possible will give women the most options.

In many cases women can take four to six weeks to preserve their fertility prior to starting cancer treatment and have time for options such as embryo freezing or egg freezing.

Egg freezing is an option that has improved dramatically over the last few years due to a faster freezing technique called vitrification. Fertility doctors stimulate a woman’s ovaries to produce eggs with fertility drugs and retrieve them in the same manner as is performed in IVF.

For girls that have not gone through puberty or women who can’t delay cancer treatment, there is an option called ovarian tissue cryopreservation in which an ovary is removed via laparoscopy, an outpatient surgery that takes 30 to 45 minutes. The procedure requires no fertility drugs and does not delay cancer treatment for more than a couple of days. Tissue from the removed ovary is sliced into strips, frozen, and stored.

Even experimental techniques like egg freezing and ovarian tissue freezing have produced babies. Egg freezing has over 1,000 babies born worldwide and ovarian tissue freezing has 15 children born worldwide. Embryo freezing is still the most successful, say infertility experts.

Fertility Preservation During Cancer Treatment

Both the male and female reproductive system are highly susceptible to the harsh effects of cancer treatment. Chemotherapy, radiation, hormones and other treatments can temporarily or permanently impair the individuals ability to have children in the future. This is why many doctors are now recommending that children and patients of reproductive age undergo fertility preservation methods prior to cancer treatment.

Egg Freezing

Considered the most successful method of fertility preservation, egg freezing allows women to protect their eggs outside of their body from harmful cancer treatments which can lead to premature ovarian failure. The technique involves harvesting the woman’s eggs through a surgical procedure and and freezing the eggs until they are ready for use. With this technique when the woman is ready to use the eggs she will need to use an IVF procedure to become pregnant.

Ovarian Cryopreservation

This newer technique is still considered an experimental procedure, however it has been showing promising results. With ovarian cryopreservation, a sample of ovarian tissue is harvested from the woman’s ovaries and either frozen in a lab or temporarily transplanted to an area safe from cancer treatment (ie: under the skin). Once the cancer treatment is complete or a woman is ready to have children, the tissue is re-introduced into the woman’s ovaries and triggers the reproductive organs to resume normal function.

Testicular Tissue Freezing

Men who are undergoing cancer treatment can have a portion of their testicular tissue harvested and frozen prior to treatment. This helps protect the tissue and the sperm-producing cells from harm and once the treatment is complete.

Testicular Sperm Extraction

This technique is a popular fertility preservation technique for men because it can be used before or after cancer treatment. It can be used in young children who do not yet have mature sperm in their semen or for men who have already undergone treatment and abnormal semen or very little viable sperm left. In this procedure sperm is extracted through a microscopic surgical procedure and preserved for later use. When a male is ready to have children, IVF and ICSI (introcytoplasmic sperm injection) are used to fertilize the sperm with an egg.

Cancer Treatment Induced Infertility Prevented With New Drug

Young women diagnosed with breast cancer may have a new option in reducing their chances for chemotherapy-induced infertility, says a new study.

According to Italian researchers pre-menopauseal women with stage I-III breast cancer had a 17% decreased risk for premature menopause (a common type of infertility) when treated with a hormone called triptorelin in conjunction with their chemotherapy.

Premature menopause, also known as premature ovarian failure, is the cessation of a female reproductive cycle in women prior to the age of 40. Women with this type of infertility are typically not able to have children on their own and must rely on the use of a donor egg or adoption.

Although the researchers are not exactly sure how the triptorelin works, they do know that it suppresses ovarian function which the chemotherapy is given, presumably reducing the amount of damage to the reproductive organs.

The study conducted is in Phase 3 clinical trials (trials on humans) but experts say that it still may be a while before this type of treatment is available to young women. The long-term effects of triptorelin on the effectiveness of chemotherapy is unknown as well as the lasting affects on fertility and pregnancy outcomes.

Currently the recommendations for preserving fertility prior to chemotherapy is by cryopreserving the woman’s eggs in an IVF cycle.