Fertility preservation refers to freezing eggs, sperm or embryos to preserve your biological family in the future. Since some cancer treatments can impair fertility, it’s wise to include this option when planning medical care treatment plans.
Health care providers who treat those living with cancer should discuss fertility preservation options as soon as possible, ideally prior to beginning cancer treatments, in order to minimise distress and enhance quality of life. This can alleviate distress while increasing quality of life.
Freeze Your Sperm or Embryos
Men can preserve their fertility by freezing semen, which can later be thawed out and used to create embryos for pregnancy. This approach is especially recommended for male cancer patients receiving treatments which could damage testicles or ovaries during treatment.
Women may freeze their eggs, known as oocytes, for future use by taking fertility medication to stimulate the ovaries and harvest multiple follicles that contain eggs that are then cryopreserved (frozen) until a later date. Oocyte cryopreservation has long been used as a method of fertility preservation with numerous healthy pregnancies and births occurring as a result.
Transgender patients can now access both sperm and egg (oocyte) freezing services, which is important when they undergo hormone therapy or surgery that could impede their reproductive capabilities.
No matter your age, discussing options for fertility preservation with your oncologist is vitally important. Preserving fertility prior to starting cancer treatments may be especially advantageous, since their effects could cause infertility sooner than expected. Some insurance plans provide coverage for fertility preservation procedures while there are organizations providing financial support.
Ovarian Transposition
Fertility preservation is an option available to men and women of both sexes who wish to maintain the possibility of biological children in the future (elective preservation). To maximize chances of preservation prior to cancer therapy being undertaken, discuss fertility preservation early with your oncologist so they may refer you to a fertility specialist and preserve your fertility before beginning their regimen.
Fertility preservation techniques such as oocyte cryopreservation (freezing unfertilized eggs) and gonadal shielding are among the most frequently employed to preserve fertility in cancer patients, and can include cryopreservation of unfertilized eggs and gonadal shielding. Furthermore, an ovarian transposition procedure may help preserve ovarian function when women undergo pelvic radiation; during this process the ovaries are moved out of the pelvis into the abdomen in order to avoid radiation damage; studies have proven its efficacy at preventing radiation-induced ovulation loss in premenopausal women suffering cervical cancer patients.
Although transposition has proven effective at maintaining ovarian function, its success cannot be assured. Radiation exposure may still impact ovulation after being relocated, thus decreasing your likelihood of successfully conceiving using this technique compared to other fertility preservation approaches. Still, several providers have reported successful pregnancies among their patients who underwent transposition for fertility preservation.
Ovarian Stimulation
At IVF clinics, a patient receives hormones to stimulate multiple follicles that contain eggs to grow. After several weeks have passed, a doctor uses a needle to extract these eggs before having them fertilized in an IVF lab before implanting them back into either her own uterus or one that will carry their baby (known as surrogacy). This procedure has proven highly successful for thousands of women across the world.
Men who wish to maintain fertility can use this option, which requires at least 12 year-old patients undergoing a testicular biopsy using minimally invasive techniques; more extensive procedures may also be necessary depending on individual circumstances.
GnRHa (gonad-releasing hormone) is a drug that may reduce the risk of chemotherapy-induced premature ovarian insufficiency in premenopausal female patients, though the results of studies regarding its use vary widely; thus this method should only be pursued if other proven fertility preservation strategies cannot.
IVF
Women and men at risk of fertility loss due to cancer treatments often opt for IVF (in vitro fertilization). This process involves extracting eggs from their ovaries and mixing them with sperm in a lab before freezing and storing them, so patients can still have biological children when the time comes.
Fertility preservation should be performed prior to starting hormone therapy or other treatments that could cause gonadotoxicity, though it can be performed at any time. Oncology nurses need to know how best to support their patients as they explore fertility options; the oncofertility patient navigator is often instrumental in this regard, helping patients assess risks and providing referrals to reproductive endocrinologists.
People may delay childbearing for various personal and career reasons. When faced with cancer or another life-threatening illness, chemotherapy, radiation and surgery treatments that may damage fertility may become necessary – or due to age issues; therefore some choose fertility preservation options ahead of beginning cancer treatments in order to ensure biological children. It is always advisable to discuss any fertility preservation plans with a fertility preservation specialist as soon as you make this decision.
