Fear and uncertainty go hand-in-hand with a diagnosis of cancer. But for younger people who hope to start a family or have more children in the future, there are even more complex issues to consider.
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“If a person is of childbearing years or younger, they should see a fertility specialist to discuss their options,” says obstetrician and gynecologist Cynthia Austin, MD.
“What’s available depends on their age and current reproductive status, and on what their oncologist says about how much time we have before they need to start treatment.”
For women, options include freezing eggs, ovarian tissue, or embryos. Men can freeze sperm for later use. Some options postpone treatment by just a few days, but others could put off treatment for 2 to 6 weeks.
Producing a semen specimen to be frozen and stored will only delay treatment by a day or so, depending on the timing of the patient’s last sexual activity. Even from the hospital, a man can produce a specimen and send it via overnight mail to a cryobank, or “sperm bank,” for storage.
If religious beliefs or the age of the patient are concerns, an oncologist or fertility specialist can give advice on other methods of collecting sperm for storage.
Collecting eggs to freeze and store will delay treatment by two to six weeks, depending on the patient’s menstrual cycle. For 10-12 days, a woman gives herself daily injections of hormones to stimulate egg development. Once her eggs are ready, they are removed in an outpatient procedure and frozen.
Embryos are fertilized eggs, so the process of egg collection begins the same way. A woman’s partner can provide sperm to fertilize the eggs, or she can use a sperm donor. Frozen embryos are more likely to result in a successful pregnancy than frozen eggs.
Freezing ovarian tissue
Surgery to collect ovarian tissue will only delay treatment by a day. Doctors remove all or part of an ovary, which is then frozen until it can be re-implanted into the patient’s body after treatment.
Collecting eggs to freeze is not an option for girls who have not yet entered puberty, but their ovarian tissue can be collected and frozen.
Do I need to protect my fertility?
All of these procedures are expensive, and may or may not be covered by insurance. But depending on the type of cancer a person has, where it is located, and how much it has spread, there might be other options for protecting the patient’s fertility during treatment.
Dr. Austin says the chance that a patient’s fertility will not be affected by treatment depends on the patient’s age, the kind of cancer he or she has, and the type of treatment that is planned.
“The most important thing to consider is whether or not these options will compromise the patient’s treatment,” Dr. Austin says.
“Sometimes fertility is not high on the patient’s agenda,” she continues. “Sometimes it’s enough to know you could use donated eggs or sperm to have a baby in the future. Whether or not to pursue fertility preservation needs to be the patient’s decision, without pressure from family members. But each patient has the option of meeting with a fertility specialist who can talk about possibilities for the future. ”
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