Oncofertility
Fertility Preservation for Cancer Patients and Survivors
Oncofertility is a medical field that bridges oncology and reproductive endocrinology. Oncofertility aims to maximize the chances that cancer patients and survivors can have a family despite their illness.
We know that life-saving cancer treatments—including chemotherapy, radiation, and surgery—can interfere with a person's ability to have children later in life. While the priority used to be surviving the cancer diagnosis, current higher survival rates mean that fertility preservation strategies are increasingly important. For women, these therapies can cause ovarian damage, early menopause, or other reproductive problems. For men, treatments can cause damage to the testes, which interferes with sperm production.
Fertility Preservation for Cancer Patients and Survivors
Oncofertility is a medical field that bridges oncology and reproductive endocrinology. Oncofertility aims to maximize the chances that cancer patients and survivors can have a family despite their illness.
We know that life-saving cancer treatments—including chemotherapy, radiation, and surgery—can interfere with a person's ability to have children later in life. While the priority used to be surviving the cancer diagnosis, current higher survival rates mean that fertility preservation strategies are increasingly important. For women, these therapies can cause ovarian damage, early menopause, or other reproductive problems. For men, treatments can cause damage to the testes, which interferes with sperm production.
Fertility Preservation Options For Women and Men
There are many options available for people with cancer to protect their fertility for the future. We encourage newly diagnosed patients to consult with a reproductive endocrinologist as soon as possible after their diagnosis.
With early action, there are treatments available to minimize the risk of infertility after recovery. Many of the fertility preservation options for women with cancer require at least a few weeks to complete, which will delay cancer treatment.
Fertility Preservation for Women with Cancer:
- Egg Banking, also referred to as egg freezing and oocyte cryopreservation, allows unfertilized eggs to be retrieved and frozen for future fertilization. During egg banking, ovaries are stimulated with hormones, resulting in the maturation of multiple eggs that can be harvested by ultrasound-guided aspiration, and then frozen for future use. This process may require 2-6 weeks to complete
- Embryo Banking, also referred to as embryo freezing and embryo cryopreservation, is the process of freezing fertilized embryos for future implantation. Ovaries are stimulated with hormones, resulting in the release of multiple eggs that can be harvested by ultrasound-guided aspiration. These eggs are immediately fertilized with sperm to create embryos, which are then frozen for future use. This process may require 2-6 weeks to complete. If a single woman prefers to freeze embryos instead of eggs, she can select an anonymous or known sperm donor.
- Ovarian Transposition is the process of moving the ovaries out of the pelvis and place elsewhere in the body before treatment. Ovarian Transposition is done before pelvic radiation treatments, where the goal is to relocate the ovaries to minimize radiation damage.
- Gonadotropin Agonist Injections (GNRH) is a medication that is used to minimize ovary or testes activity before chemotherapy. Ovaries and testes with lower metabolic activity will face fewer damaging effects from chemotherapy, although that view remains controversial.
- In Vitro Maturation (IVM) of Oocytes is the process of developing immature female egg cells into mature eggs. In this treatment, multiple oocytes are harvested by ultrasound-guided aspiration without prior hormone stimulation. Oocytes mature in the laboratory, either before or after freezing. The advantage of this process is the relatively short time required to obtain immature eggs, which minimizes any delay before cancer treatment. Scientists are currently developing methods to optimize the maturation process of eggs in the laboratory.
- Tissue Banking is the process of surgically removing and freezing ovarian cortex or testicular tissue. The tissue can later be transplanted back into the body and hormonally stimulated to produce eggs and sperm when you are ready to conceive. This procedure yields some success, but scientists are currently developing methods to optimize the technique.
Fertility Preservation for Men with Cancer:
- Gonad Shielding: If possible, the genital and pelvic region is protected with a lead apron during radiation therapy to minimize radiation damage to ovaries and testes.
- Sperm Banking is the process of freezing sperm for future use. Ideally, multiple semen samples are collected and frozen over a period of several days.
- Sperm Banking allows sperm to be frozen for future use. Multiple semen samples can be collected and frozen over a period of several days.
- Testicular Sperm Aspiration or Extraction is a minor surgical procedure where sperm is retrieved directly from the epididymis or testes, which can then be frozen for future use. This process is only required when there is not enough sperm produced through ejaculation.
Having a Baby After Cancer
Having a baby after cancer doesn’t have to mean that your dreams of having a child are over. There are many potential treatments, and we recommend seeing an infertility specialist as early as possible to maximize your treatment options. We encourage you to book an appointment with an oncofertility expert at one of our convenient locations (Houston, Dallas, San Antonio, Austin or Atlanta) to learn more about fertility preservation options and how we can help you preserve your dream of parenthood.
