Preserving Fertility in Women with Cancer

Often treatments for cancer, such as cancer-related surgery or higher doses of chemotherapy or radiation, can cause ovarian failure and affect fertility. With recent advances in oncology and the treatment of cancer, options are increasing to maintain the reproductive process for both men and women.

Effects of Chemotherapy and Radiation on Fertility

As damage to the ovaries by chemotherapy and radiation cancer treatments can worsen and be irreparable, the absence of menstrual periods (amenorrhea) and infertility can occur. Medical studies show that lower doses of radiation can cause premature ovarian failure with higher doses causing permanent ovarian insufficiency. Rates of infertility can vary depending on the age of the patient, levels of dosages and the duration of the cancer treatment.

The uterus may also become damaged from radiation performed to the abdominal region. Even radiation to the head can cause infertility by blocking the production of reproductive hormones occurring in the brain. Although there is a possibility of damage to the ovaries with cancer treatments, medical studies report little chance of toxicity to the offspring and future births of women receiving the chemotherapy.

Medical studies indicate that women in their 30s or younger can tolerate higher doses of chemotherapy with less fertility damage than women in their 40s and older.

The Contraceptive Pill and Fertility Preservation

A small medical study showed improved follicles (group of cells found in the ovary containing the woman‘s lifetime supply of eggs) with the use of a contraceptive pill in conjunction with chemotherapy treatments. A hormone pill, however, may not be a possible choice for all women undergoing cancer treatments. Estrogen positive breast cancer patients or those that have hormone-sensitive tumors may not be good candidates for this preservation method. The oncologist will know what is the best option for the women’s particular circumstance.

Cryopreservation

Medical studies show that cryopreservation and the freezing of unfertilized eggs and successful future pregnancies are not yet possible, but the freezing of fertilized eggs has shown success. Embryo cryopreservation allows embryos to be frozen and healthy usually for up to about 10 years.

The cost for embryo freezing is usually about $600 in the United States with a yearly charge of $100. A typical frozen embryo transfer (FET) procedure costs normally about $3,000.

Ovarian Tissue Cryopreservation

Ovarian tissue cryopreservation is a new option available for girls who have not yet reached puberty. This method is also ideal for women who cannot delay cancer treatments while taking hormones to stimulate egg production.

With this procedure, an ovary is removed laparoscopically (small incision is performed with the aid of a camera). This is normally done on an outpatient basis taking usually only about 45 minutes at the most. The surgery can be performed without the use of hormones and usually only causes a delay of cancer treatments of about two days.

Ovarian tissue cryopreservation may be a preservation choice for fertility for some women with cancer.

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