As if the news that you have cancer isn’t devastating enough, there is the reality that the most common treatments for cancer, including radiation and chemotherapy, can render you infertile. This is true for both women and men. If you or your spouse are diagnosed with cancer, and plan to start a family in the future, make an appointment to speak with both your doctor and a fertility specialist, and begin to make a plan. The steps you take now, before your cancer treatment begins, may allow you to have a child of your own in the future.
- Learn about how your cancer treatment affects fertility.
–For men: Male fertility will be affected by surgical removal of the testicles, and can also be affected by radiation or chemotherapy. Both radiation and chemotherapy can cause low sperm count, poor motility, or can harm sperm DNA. In some cases, cancer treatments can affect ejaculation or cause hormonal problems.
–For women: Some cancer treatments require the surgical removal of the ovaries or uterus. Radiation and/or chemotherapy can compromise hormone levels, egg health, and healthy function of the reproductive organs. Women also have a chance of experiencing early menopause following their cancer treatment.
Fertility issues are more likely in patients who require high doses of radiation or chemotherapy, or when radiation targets the reproductive organs.
- Ask the right questions. It can be difficult to think clearly about your reproductive risks and options as you and your partner navigate the issue of cancer itself. Use this link to Fertility Preservation on the cancer.net website as a resource and ask the right questions ahead of time.
- Request Gonadal Shielding if possible. If you require radiation that is not directed at your reproductive organs, request the highest levels of gonadal shielding possible. This can help to protect your reproductive organs from the negative effects of radiation, and may be enough to preserve fertility.
- Fertility preservation options for women. Women have a range of fertility preservation options, all performed prior to your cancer treatment. Your oncologist and fertility specialist can help you determine which method is best for your situation.
–Embryo Cryopreservation. This is also called in-vitro fertilization, IVF, where the sperm and egg are removed and fertilized in the clinic. In this case, all of your embryos will be cryogenically frozen and safely preserved until you are ready to use them yourself, or via a surrogate mother should you no longer be able to carry a child.
–Egg Freezing (oocyte cryopreservation). If you have not yet met the partner of your dreams, your eggs can be matured and harvested via hormonal stimulation prior to your cancer treatment. They will be frozen cryogenically and you can use IVF when you are ready to become pregnant.
–Ovarian transposition (oophoropexy). This outpatient surgical technique is used if you are going to have radiation in your pelvis, but do not require chemotherapy. Surgeons can actually reposition your ovaries to keep them as far away from the radiation as possible. Once your treatments have concluded, your ovaries can be repositioned. In some cases, this is enough to preserve fertility. In others, women may need to use IVF in order to conceive.
–Trachelectomy. Trachelectomy, or removal of the cervix, is an inpatient surgery performed for women with early-stage cervical cancer. Fertility is not harmed in any way and most women are able to have a healthy pregnancy with minor modifications.
- Fertility Preservation for Men. Outside of gonadal shielding, mentioned in #3, the sole option for men is sperm cryopreservation. Sperm samples are provided via masturbation or testicular aspiration. They are cryogenically frozen and can be stored for years. Your mate can conceive via artificial insemination or IVF procedures in the future.
If you or your partner are diagnosed with cancer, please contact a fertility specialist as soon as possible so you can discuss your options with professionals. Taking care of this most important step will leave you with one less worry as you navigate your road to recovery.