EMERGENCY: 1800 330 0000 I CALL: NOIDA : +91-9582833333, GREATER NOIDA : +91-8800447777, NOIDA EXT: +91-8800110086 , JHANSI: +91 8800550084, FARIDABAD: +91-8588833310

Fertility Preservation: Options For Cancer Patients And Career-Focused Individuals

Most cancer treatments can combat the condition effectively. However, some side effects may be an issue, including the harm to healthy tissue and the possible impact on fertility. In the latter, the impact may be short or long-term.

Surgery, radiation, chemotherapy and hormone therapies are some cancer treatments that may affect fertility. In surgery, the reproductive organs (ovaries, uterus or testicles) may be removed. If radiation therapy is administered in the pelvic area, high doses could damage the reproductive organs and destroy ovarian eggs. In chemotherapy, sperm in males and eggs or hormone levels in females may be affected, depending on the drug used and the dosage. In women with breast cancer, hormone therapies could affect fertility, although these effects are typically temporary.

The good news is that men or women do not need to worry as there are multiple fertility preservation techniques one could take before beginning any cancer treatment. Visiting a fertility specialist to know these options will be helpful. A timely visit is important because even one cancer therapy sitting could impact fertility. In the case of women, some fertility preservation treatments are usually done in specific stages of the menstrual cycle, therefore prior planning is essential.

Note that the options mentioned below for both males and females can also be useful for those without cancer. Such individuals may wish to preserve their fertility because of late marriages or career-centric lives that presently preclude the possibility of bearing children.

The Options for Women

The various options for women to preserve fertility before undergoing cancer treatment are:

  • Embryo cryopreservation: Herein, the eggs are harvested and fertilised before being frozen and preserved for implantation in future. Research indicates that up to 90% of the frozen embryos survive the process of freezing and thawing.
  • Egg freezing: Here, the woman’s unfertilised eggs will be harvested and frozen.
  • Ovarian transposition: In this treatment, the ovaries will be repositioned surgically in the pelvic area to keep them away from the radiation field before radiotherapy begins. Nonetheless, since radiation can scatter, the ovaries may not be fully protected. Once the treatment is done, the ovaries will be repositioned to facilitate conception.
  • Radiation shielding: To limit radiation exposure to the ovaries, small lead shields will be placed over these organs.
  • Removal of the cervix surgically: Before treating early-stage cervical cancer, a big cone-shaped part of the cervix, which includes the cancerous portion, will be removed. The remaining part of the organ (plus the uterus) is preserved. Conversely, the cervix plus the connective tissues near the uterus and cervix can be removed partially or wholly.

Some Options for Men

Similarly, males have some options to preserve fertility before they begin cancer therapy.

  • Sperm banking or sperm cryopreservation: This is an inexpensive option, where an individual’s sperm is collected and frozen. Safely stored for years in a sperm bank or fertility clinic, it can be used anytime later. This procedure is effective even if a man has a low sperm count. Also, the cancer therapy won’t be delayed too much for this option.
  • Testicular sperm extraction: A surgical procedure is done to extract sperm cells and collect tissue from the testicles. The cells are then preserved for later use.
  • Testicular tissue cryopreservation: A new, innovative option, it’s useful for fertility preservation in pre-pubescent males who still do not produce sperm. A section of the testicular tissue is removed surgically and frozen for later use.
  • Radiation shielding: For this, the testicles are safeguarded by placing small lead shields over them, limiting their radiation exposure.

The Options for Children

Besides adults, sometimes a child could develop cancer, leaving parents worried about the impact of the treatment on his/her fertility. In such situations, parental consent may be required to initiate any fertility procedure. However, the child will also need to be aware of what is being undertaken, if he or she is old and mature enough to understand.

If puberty has begun, options may include sperm or egg cryopreservation. Females undergoing cancer therapy before puberty may choose ovarian tissue cryopreservation. For this, the ovarian tissue will be extracted surgically, frozen and thawed later before re-implantation.

For pre-pubescent boys seeking to preserve fertility before going in for cancer therapy, the option is to remove their testicular tissue surgically and have this frozen for subsequent use.

Impact of Fertility Treatment on Cancer Therapies

No evidence exists that fertility treatments can compromise cancer therapy outcomes directly. Yet, an undue delay in surgery or radiotherapy sessions till fertility preservation is done may compromise successful treatment outcomes. Therefore, cancer therapy should always begin at the earliest, as per the doctor’s advice.

Also, though there may be no heightened risk of cancer recurring due to most fertility treatments, re-implanting frozen tissue could lead to a reintroduction of cancer cells. This will depend on the cancer type and its stage as well as whether the frozen tissue was extracted from a cancerous region or not.

Cancer Therapies and the Likelihood of Health Issues in Children

If a baby isn’t exposed in utero to cancer treatments, these won’t possibly raise any risks of congenital conditions or health issues in children born later. Nonetheless, if a woman is due to undergo cancer therapy that affects the functions of the lungs or heart, or if radiation is given in her pelvic region, it’s advisable to consult a specialist before pregnancy. The doctor can then guide her on how to avoid or prepare for any likely complications during pregnancy.

How Does One Determine the Best Fertility Treatment?

The best approach for an individual is determined by the medical team, depending on the type of cancer, the treatment plan, and the overall time available before the treatment begins.

Any cancer diagnosis can be overwhelming for the patient, making it difficult to decide other things. Nevertheless, whatever queries or concerns one has can be better resolved by consulting specialists without any delay. Informed choices can be made on fertility preservation by acting in time.

Fertility Options After Cancer Therapy

In some instances, a cancer patient may prefer to postpone fertility treatment and, instead, undergo cancer therapy immediately. Even in such situations, multiple options are there for patients wanting to become parents. These include donor eggs, donor embryos, donor sperm, in-vitro fertilisation, and gestational surrogacy.

Couples or individuals could choose a single service or a series of services to experience the joy of parenthood. Consulting a fertility specialist will help decide the best course of action for one’s family.