Cancer treatments vary in their likelihood of affecting the ability to have children in both men and women.
For female cancer patients, 40-80 percent become infertile after cancer treatment, while 30–70 percent of male cancer patients become sterile. It is important that patients are aware of fertility preservation techniques available to those that choose to have children in the future.
Fertility preservation options for women include:
Embryo freezing: Retrieving eggs from the female partner and fertilizing with the male partner’s sperm. The resulting embryo is then frozen or cryopreserved to be transferred at a later time (after completion of the cancer treatment)
Egg freezing: If the patient does not have a partner, freezing her eggs or “oocytes” is an ideal alternative to embryo storage. It is a newer technology and may not be as successful as embryo freezing, but still is a very good option.
Ovarian tissue freezing: This is an emerging technology that may be the only option for prepubertal girls or for those who cannot delay cancer treatment or who are unwilling to undergo ovarian stimulation. It requires surgery to harvest a part of the ovary and then freeze this for later use.
Ovarian suppression with medication: Medications can be given that “protect” the eggs against the harmful effects of chemotherapy. This is not as well studied and may not be successful, but it is the least invasive option prior to beginning chemotherapy.
Moving the ovaries out of the radiation field: Surgery is sometimes helpful to surgically remove the ovaries out of the pelvis and reattaching them to a place where they wouldn’t be subject to such a high dose of radiation.
Fertility preservation options for men include:
Sperm Freezing: Prior to cancer treatment, a man can collect and cryopreserve several vials of sperm for later use. This technique has been available for many years and is considered very safe and effective.
Testicular sperm extraction or testicular tissue freezing: If a man is going through surgery for his treatment, it may be reasonable to extract viable sperm from the testicle or epididymis at the same time (or remove viable testicular tissue). This must be arranged ahead of time with the lab to ensure there are normal sperm present.
Talk with your oncologist before treatment
To help patients determine if they are candidates for any of these options, they should discuss with their oncologist as soon as possible regarding the potential effects of their medicine on their future fertility. They need to ask:
- How can the cancer affect my fertility?
- How can the cancer treatment affect my fertility?
- How quickly do I need to start treatment?
- How much time will I have to preserve my fertility before starting my cancer treatments?
Your oncologist may refer you to a reproductive endocrinologist who will discuss in greater detail all of the options available, so you can make an informed decision.