Fertility Preservation for Men and Women with Cancer
Medications such as chemotherapy and or surgical treatments used to treat cancer can impact future fertility. For example, some types of chemotherapy can damage and even deplete a woman’s oocytes (eggs) or destroy a man’s ability to make sperm. Furthermore, many cancer patients are advised to delay pregnancy for a period of time after treatment due to the risk of cancer recurrence. The reason being if a woman were to conceive during a high-recurrence risk period, it could be more difficult to monitor her for cancer recurrence, and if she were to have a recurrence it may be more difficult to treat the cancer. This time delay in child-bearing could have a big impact on a woman’s chance of having children if she is in her mid to late thirties when age-related decline in fertility becomes particularly important.
For many patients, fertility can be preserved prior to, or sometimes during, treatment. The specialists at the Washington University Fertility and Reproductive Medicine Center will work with your oncologist to help you understand the options that are available to you.
As a member of the National Physicians Cooperative of the Oncofertility Network, we have multiple reproductive specialists who deal specifically with men, women and their partners looking for options regarding fertility preservation.
If you feel that fertility preservation is right for you, call and make an appointment with one of our specialists at 314-286-2498.
Female fertility preservation
This is a successful and well-studied choice for fertility preservation. It requires both oocytes (eggs) and sperm to create embryos. Oocytes are removed from the woman during a minor procedure, after hormone stimulation. The eggs are fertilized with sperm and the resulting embryos are frozen. Once cancer treatment is over and the woman is ready to conceive, an embryo is tranferred into the uterus.
Oocyte (egg) cryopreservation
This process is similar to the one above, except it does not require sperm. A woman can choose to have unfertilized eggs preserved. In October 2012, the American Society of Reproductive Medicine lifted the “experimental” label on this technique, citing “evidence that ‘demonstrates acceptable success rates in young highly selected populations.’”
Recognizing that egg or embryo freezing can be cost-prohibitive, the Fertility and Reproductive Medicine Center has signficantly discounted the cost of these services for patients who do not have fertility benefits through their insurance provider.
Ovarian tissue cryopreservation and transplantation
This is currently experimental and is not yet a standard therapy. It remains a choice for prepubertal girls and for women whose cancer diagnosis does not allow the time required for oocyte or embryo freezing. If a patient elects to proceed with this, it requires laparoscopic surgery to remove ovarian tissue. The ovarian tissue is frozen. After completion of the cancer treatment, the ovarian tissue is thawed and transplanted back into the patient.
Giving a GnRH agonist (ie. Leuprolide or LUPRON) has been thought to be protective to the ovary against the toxic effects of chemotherapy. Current literature does not yet support this as a standard treatment but it remains an experimental option when embryo, egg freezing are not feasible.
Male fertility preservation
We offer cryopreservation (freezing) of sperm for male patients. Sperm is obtained by ejaculation or, in rare cases, with a minor operation directly from the testicle. The sperm is then cryopreserved (frozen) and saved for later use. Once frozen, sperm may be preserved for many years. The samples can be used for artificial insemination if the sperm counts are adequate or in vitro fertilization with intracytoplasmic sperm injection.