More than 130,000 men and women in their reproductive years are diagnosed with cancer each year. For some, this may seem like the end to their dream of starting a family, but that’s not always the case.
“With early detection and increasingly effective treatments, more patients are surviving cancer and want to start families,” said
Dr. Michelle Mathews, Director of Fertility Preservation at
Carolinas HealthCare System's
Levine Cancer Institute. “Exciting new advances have increased options for patients who want to preserve fertility prior to initiating cancer treatments that may otherwise leave them infertile.”
Cancer Treatment and Infertility
Certain cancer treatments can permanently or temporarily impair fertility, including chemotherapy, radiotherapy and surgery on reproductive organs. How cancer treatments affect fertility depends on the type of cancer, the treatment and the patient’s age at the time of treatment.
“Many who are treated for cancer, especially children, can remain fertile and have a family of their own with few issues,” said Dr. Matthews. “But often it can be difficult to know what the effects the cancer treatment will have on fertility until later in life.”
Preserving Fertility for Men
Cancer treatments can affect men’s fertility by stopping the production of sperm or testosterone or by damaging nerves and blood vessels in the pelvic area.
To preserve fertility for men, sperm may be frozen prior to cancer treatment and stored for future use.
“Healthy pregnancies have been reported with sperm that has been stored for 20 years,” said Dr. Matthews.
For patients who do not store sperm prior to chemotherapy or radiation and subsequently have extremely low sperm counts, there are techniques to obtain sperm directly from the testicle to use for achieving pregnancy through in vitro fertilization (IVF). IVF is a process where a woman’s egg is fertilized with sperm outside the body and then transferred back into the uterus.
“This offers a man the opportunity to have a child using his own sperm if he did not store any prior to cancer treatment,” said Dr. Matthews.
Preserving Fertility for Women
Cancer treatments for a woman often permanently deplete her supply of eggs or prevent the ovaries from working properly, which causes early menopause. Treatments also can lead to damage to – or removal of – the womb.
“While men continually produce new sperm, women are born with all of the eggs they will ever develop,” said Dr. Matthews. “Although sperm are relatively easy to freeze prior to cancer treatment, freezing eggs is more difficult and was not effective until recently.”
Dr. Matthews indicated that exciting advances in fertility preservation have expanded options for women. More than 2,000 pregnancies have been reported using a new and effective technique to freeze eggs called “vitrification.”
“Vitrification is a freezing technique that results in approximately 90 percent of eggs surviving the process,” said Dr. Matthews. “Pregnancies have also been established by freezing portions of the ovary prior to cancer treatment and then transplanting them back after completing chemotherapy or radiation.”
Although this technique is still in development, it may allow patients to conceive naturally and holds significant promise for the future.
Pregnancy and Cancer Treatment
Women are not advised to get pregnant during cancer treatment and men are advised to use contraception or abstain from having sex. After treatment, patients should speak to their doctor about how long to wait before it will be safe to get pregnant.
“A diagnosis of cancer can be overwhelming and not all patients elect to preserve sperm or eggs prior to starting treatment,” said Dr. Matthews. “Fortunately, options are available after cancer to help patients conceive naturally or with assistance. For many patients, simply understanding how cancer impacts fertility can empower them to make decisions that provide hope for their future.”
