If you are diagnosed with cancer, you may need to make decisions about your fertility sooner than you had planned. Cancer and some types of treatment can damage sperm in men and eggs in women, and sometimes, the reproductive system. It is important to know your options to preserve your fertility before you begin treatment.
Laxmi A. Kondapalli, MD, MSCE, reproductive endocrinologist at the Colorado Center for Reproductive Medicine, a partner of Sarah Cannon Cancer Institute at HealthONE in Denver, suggests fertility preservation for young female and male cancer patients (under 39) who are of childbearing age and think they may want children in the future, or older men who still may want their fertility.
When someone is diagnosed with cancer, there are so many decisions to be made all at once, which can be overwhelming, says Dr. Kondapalli. With women and men now waiting later in life to have children, the chance of developing cancer during the childbearing years is increasing.
Key considerations for fertility preservation are:
- Age at diagnosis
- Cancer diagnosis
- Type of cancer treatment
- Whether the cancer has spread to reproductive areas
- The timeline for fertility preservation
Many patients are concerned about fertility preservation because it may cause a time delay in starting treatment. However, through recent advancements, the time it takes to preserve fertility is now much shorter than it was previously.
In the past it would take six to eight weeks to stimulate the ovaries to freeze eggs or embryos in women who were about to undergo cancer treatment, says Dr. Kondapalli. Now, in many cases, this process can take less than two weeks and allows the patient to start her cancer treatment much sooner.
So, why is fertility preservation important even if the cancer is not near reproductive organs?
Cancer survivors may face infertility issues or pregnancy complications due to their cancer treatment. Once eggs or sperm are exposed to chemotherapy or radiation, it becomes difficult to test whether they have been affected by the treatment.
If you think you might want to start a family, or add to your current family in the future, Dr. Kondapalli encourages you to ask for a referral to a fertility expert who specializes in oncofertility. She also assures patients who may not be able to complete fertility preservation before starting treatment, that not all options are depleted.
It is common for cancer survivors to undergo fertility testing following their cancer journey to find out their status, says Dr. Kondapalli. I usually recommend that cancer survivors wait for about 12 months after completing their treatment before fertility testing as the ovaries and testes may naturally recover. After the year has passed since treatment, results of fertility tests are also more accurate.
What if cancer runs in my family?
Some cancers are related to specific genes (short pieces of DNA) that predispose a person to the cancer. For example, mutations in the BRCA gene are associated with an increased risk of breast and ovarian cancer. These genes are inherited in an autosomal dominant pattern, which means that every child has a 50% chance of inheriting BRCA when the mother has the mutation. Through preimplantation genetic diagnosis after in vitro fertilization, embryos can be screened for BRCA and unaffected embryos can be selected to transfer and achieve a pregnancy.
If you have questions about fertility preservation, call askSARAH at (844) 482-4812 to speak to a nurse who is specially-trained to help with your cancer questions.