Imagine receiving a cancer diagnosis when you're trying to get pregnant or are considering pregnancy in the future. Fortunately, with advances in treating cancer and options to preserve fertility, cancer survivors may still be able to start or add to their family.
While you'll want to focus on treatment for your condition, if your plans include having children, you'll also want to understand the impact on your fertility and consider options to help improve your chances of getting pregnant later - before starting cancer treatment. That doesn't always happen and health professionals recognize they can do better.
According to research presented at the recent annual meeting of the American Society for Reproductive Medicine (ASRM), two studies revealed even the country's top cancer centers don't always provide adequate information about fertility preservation, especially to lower income women, women of color and men.
Patient support group RESOLVE suggests that being well-informed about how cancer affects your fertility, and what you can do about it, offers a sense of control when you need it most.
Whether cancer treatment will affect your fertility depends on your age, the type of cancer and your specific treatment. These factors also inform what may work best as you try to improve your chances of having a baby. Chemotherapy, radiation or a combination, are most often used to treat the types of cancer that affect young women, including Hodgkin or non-Hodgkin lymphoma, leukemia, thyroid cancer, breast cancer, melanoma, or gynecologic cancers (cervix, uterus, or ovary).
Chemotherapy is effective in treating many cancers, but specific drugs and dosage can harm or decrease the number of eggs, resulting in infertility. With radiation, both dose and location make a difference. And, surgery on your reproductive system including the cervix, ovaries and uterus can also impact your future fertility.
There are promising options to preserve fertility and most use the relatively new technology of vitrification, also called rapid cryopreservation or freezing.
Specific options include:
Embryo freezing, the most common and successful method to preserve fertility usually involves stimulating hormone shots over 2-3 weeks to develop eggs, egg retrieval and in-vitro fertilization (IVF). This may not be the best option for women who must immediately start treatment as the entire process takes 2-5 weeks, or for those who should not be exposed to high estrogen levels because of their type of cancer.
Egg freezing also usually requires hormone shots to stimulate egg production before they can be harvested, then frozen. An experimental approach involves harvesting immature eggs that require no prior hormonal stimulation. Eggs are matured in the lab and frozen for later use. To date, there are few published reports on live birth success rates.
Ovarian freezing is a new experimental technique using tissue removed from one ovary that contains resting eggs. The tissue is sliced thinly, frozen, then thawed and returned to your body after cancer treatment. Major disadvantages include a low success rate and the need for multiple surgeries. It may be an option of last resort for women under 35 if cancer treatment must start immediately or where hormone stimulation is not an option.
GnRH agonist treatment or ovarian suppression is an experimental approach that creates a temporary menopause that may reduce the number of eggs damaged during chemotherapy or radiation through a monthly shot given two to three weeks before treatment until treatment ends. Results are unclear so it might be considered in conjunction with an additional preservation method such as embryo freezing.
Today's advances in medical treatment have helped more cancer survivors start or add to families. To optimize your results, work closely with your oncologist and consult a fertility specialist immediately - before treatment. That way, you can make the best decision for your health and your future family.
For more information on fertility preservation and women's health visit www.arcfertility.com.