Certain malignancies and their treatment may impair male and female fertility. When a cancer patient wishes to have children after treatment, some preparation is necessary. Occasionally, this entails fertility preservation. Fertility preservation is the process of storing or protecting eggs, sperm, or reproductive tissue in order to utilize them to produce children in the future.
Fertility preservation for females with cancer
Certain forms of cancer surgery may result in the loss of organs necessary for conception, and certain therapies may alter a female’s hormone levels or destroy her eggs. These side effects cause some females to lose their fertility temporarily or permanently after therapy. Continue reading How Cancer and Cancer Treatment Affect Female Fertility. Some women may want to take precautions to protect their fertility in order to attempt pregnancy after therapy.
It is preferable that conversations regarding maintaining fertility occur prior to cancer surgery or treatment. Do not expect that your doctor or nurse will inquire about your reproductive concerns. They may not always remember to bring this up, so you may have to do it yourself.
If you’re contemplating taking efforts to maintain your fertility and it’s feasible, make sure you understand the dangers and likelihood of success associated with any fertility option you’re considering, and bear in mind that no approach is guaranteed to work 100% of the time.
Additionally, it is important to discuss with your cancer care team if you are permitted to have unprotected sex both during and after cancer treatment. They may advise you to wait several months or more before attempting to conceive a child naturally or before having unprotected sexual intercourse.
Experts suggest that members of the cancer care team, such as medical oncologists, radiation oncologists, gynecologic oncologists, urologists, hematologists, pediatric oncologists, surgeons, and nurses, be included in discussing fertility with patients.
• The cancer care team should discuss any potential reproductive issues that may arise as a result of therapy as soon as feasible, either before to surgery or before treatment begins.
• Patients who are considering fertility preservation, or who wish to learn more about it, should be referred to a reproductive expert.
• The cancer care team should also begin discussing fertility preservation as soon as possible, ideally before treatment begins.
• Individuals who are frightened or upset about fertility-related symptoms should be referred to therapy.
Possible natural pregnancy
Females who were fertile before to therapy may have a spontaneous recovery. It may be capable of preserving or reestablishing regular hormonal cycles. and develop mature eggs capable of being fertilised and inserted into the uterus to form a child. The medical staff may propose waiting between six months and two years before attempting to conceive. Waiting six months may help lower the chance of birth abnormalities caused by chemotherapy or other therapies that harm the eggs. The two-year term is often predicated on the idea that the risk of cancer returning (recurrence) is greatest during the first two years after therapy. The duration of therapy is determined by the kind of cancer and the type of treatment utilised.
However, women who have had chemotherapy or radiation to the pelvis are also at risk for premature menopause, even when they resume menstrual cycles. Menopause may begin five to twenty years sooner than anticipated. As a result, women should discuss with their physicians how long they should wait before attempting to conceive and why they should wait. It is preferable to have this talk before to proceeding with a pregnancy plan.
Cryopreservation (freezing embryos or eggs)
Cryopreservation, the freezing of embryos or eggs, is recommended by experts to help maintain fertility in some females with cancer. It is critical to choose a fertility expert and treatment facility with experience doing these procedures.
The technique of egg collection for embryo and egg freezing is same. However, the time may vary. Egg collection for cryopreservation of embryos often takes several days or weeks, depending on the stage of a woman’s menstrual cycle. Females get injectable hormone medicines when it is safe to do so. The menstrual cycle is not critical for egg cryopreservation. Both procedures include inserting a catheter through the upper vagina and into the ovary to extract the eggs.
Costs for these treatments vary, so check with your insurance carrier for coverage details and with the reproductive expert to determine the total cost of the surgery. Occasionally, these expenditures might exceed $10,000 or more per job, which may or may not include storage fees. Always get a list of all fees and charges, since they vary each facility.
If you have frozen eggs, embryos, or ovarian tissue, it is essential to maintain contact with the cryopreservation facility in order to ensure that any annual storage costs are paid and that your address is updated.
Embryo freezing
Embryo freezing, or cryopreservation, is an efficient method of preserving female fertility. The female’s mature eggs are retrieved and placed in a sterile laboratory dish along with several thousand sperm. The objective is for one of the sperm to fertilise the egg after that. This procedure is referred to as in vitro fertilisation (IVF). Intracytoplasmic sperm injection (IVF-ICSI) is a procedure that includes injecting a single sperm directly into an egg to fertilise it. The lab dish is examined during both IVF and IVF-ICSI, and if the egg is fertilised, the embryo may be frozen. Later, when the woman’s therapy is complete and she is ready to attempt conception, the embryo is thawed and reintroduced into her uterus in an attempt to establish pregnancy.
Age and menopausal status of a woman have a significant impact on her odds of conception, with a younger age at the time of egg retrieval resulting in a greater likelihood of pregnancy. The embryos’ quality also matters. Some may perish during the defrosting procedure. Some may not implant properly into the uterus.
Egg (oocyte) freezing
Egg freezing (or egg cryopreservation) is another efficient method of preserving women’s fertility, albeit it has not been utilised as extensively as embryo freezing (described above). This may be a viable option for women who do not have a partner, do not want to utilise donor sperm to create a fertilised embryo, or have a religious objection to freezing a created embryo.
Egg freezing involves the removal of mature eggs from the female and freezing them prior to fertilisation with sperm. This procedure is sometimes referred to as egg banking. When the woman is ready to attempt pregnancy, the eggs may be frozen, fertilised with sperm from a partner or donor, and put in her uterus to attempt pregnancy.
Ovarian tissue freezing
This method is still in its infancy. It entails the removal of all or part of one ovary by laparoscopy (a minor surgery where a thin, flexible tube is passed through a small cut near the navel to reach and look into the pelvis). Typically, ovarian tissue is sliced into thin strips, frozen, and kept. The ovarian tissue may be frozen and implanted into the pelvis after cancer therapy (transplanted). Once the transplanted tissue resumes normal function, the eggs may be retrieved and fertilised in the laboratory.
Typically, ovarian tissue removal does not necessitate hospitalisation. It may be performed before to or after puberty.
Ovarian transposition
Ovarian transposition is the process of relocating the ovaries away from the radiation therapy target zone. It is a common procedure for girls and young females undergoing pelvic radiotherapy. It may be used before to or after puberty.
This treatment is often performed as outpatient surgery and does not need hospitalisation (unless it is being done as part of a larger operation). The ovaries are often relocated above and to the side of the central pelvic region by surgeons. It is normally advisable to do the operation just before to beginning radiation treatment, since they tend to revert to their natural position over time.
This technique has a variable success rate. Ovaries are not always protected due to radiation dispersion, and patients should be advised that this method is not always effective.
It’s difficult to estimate the cost of ovarian transposition since the treatment is often performed in conjunction with another procedure that is covered by insurance.
Fertility-sparing surgery
When cervical cancer is detected early, the surgeon may be able to remove the cervix (trachelectomy) without removing the uterus or ovaries. For early-stage ovarian cancer that affects just one ovary, the surgeon may be able to remove only the afflicted ovary. Both of these treatments may aid in fertility preservation. For further information, please see the photos below.
Ovarian suppression
Agonists of gonadotropin-releasing hormone (GnRH) are long-acting hormones that may be used to induce menopause in a woman for a brief period of time. This condition is referred to as ovarian suppression. The purpose of this therapy is to completely shut down the ovaries during cancer treatment in order to safeguard them from any harmful side effects. The expectation is that by lowering ovarian activity during therapy, the amount of damaged eggs will be reduced, allowing patients to resume regular menstrual cycles after treatment. However, the consequences of this medication as a means of preserving fertility remain unknown. Experts do not propose ovarian suppression in lieu of cryopreservation or other established techniques of fertility preservation.
The expense of hormone injections may be costly, and the medications can weaken bones if taken for an extended period of time. Due to the fact that the medications induce menopause in women, the most prevalent adverse effect is hot flashes.
People also search
How can I keep fertility during chemo?
Experts recommend freezing embryos or eggs, called cryopreservation, to help preserve fertility for certain females with cancer. It’s important to find a fertility specialist and center that has experience in these procedures. The process of collecting eggs for embryo and egg freezing are the same.
Are you fertile during chemotherapy?
Many chemo drugs can hurt a developing fetus, causing birth defects or other harm. Some can contribute to having a miscarriage. Some women remain fertile during chemo, so it’s best to use very effective birth control. Remember, too, that some women can get pregnant even when their periods have stopped.
What supplements should not be taken during chemotherapy?
Echinacea, curcumin, St. John’s wort, valerian root, and allium (an extract of garlic) — all are examples of herbal supplements that can disrupt the toxicity-efficacy balance of chemotherapy.
What are the chances of getting pregnant while on chemo?
Only approximately 10% maintained the desire to become pregnant after chemotherapy. Of six patients who still wanted to have children, four became pregnant, though two of these ended in a miscarriage
