Creating a family after cancer

Some cancer treatments can affect your fertility, either by removing reproductive organs such as the ovaries or testicles, or by receiving chemotherapy or radiation that affects hormones or harms the quality of eggs or sperm. If you are about to undergo treatment and wish to preserve your fertility, it is essential that you speak with your oncologist as soon as possible about your options. The sooner you express your concerns about your fertility, the more options you will have. Many patients are so focused on the cancer itself that taking steps to preserve their fertility may not be one of their primary concerns. But as treatments improve, many cancer patients are able to live longer with the expectation of resuming their normal lives when treatment ends, which can often include creating or increasing their families.

start the conversation

Start a conversation with your doctor by asking about these topics:

Cryopreservation of eggs and embryos. In these procedures, a woman receives an injection of medication at the beginning of her period to stimulate the ovaries to produce multiple eggs that can be collected and frozen for later use. Unfertilized eggs can be frozen on their own or combined with sperm to form frozen embryos. This process usually delays treatment by two to four weeks, but can be coordinated around other planned treatments (including surgery) or by resetting the menstrual cycle with medications to reduce the risk of delaying treatment. Studies now show that pregnancy results from frozen eggs are comparable to fresh eggs, thanks to a newer freezing technology called vitrification, which reduces the formation of harmful ice crystals inside the egg.

Sperm freezing. This procedure for men is very simple: the patient provides a semen sample, which is then frozen and stored for later use in IVF (in vitro fertilization).

Ovarian replacement (ovarian fixation). Women planning radiation therapy to their pelvic area may opt for this procedure, which moves the ovaries away from the radiation target sites, bringing them closer to the ribs to reduce exposure to harmful radiation. In addition to attempts to protect the integrity of the eggs’ genetic material, shunting also aims to reduce the incidence of ovarian failure (early menopause).

Radical resection of the trachea. Women with early-stage cervical cancer may be candidates for this surgery, which involves removing the cervix and wrapping a small tape around the lower part of the uterus to replace it. This treatment is designed to help improve a woman’s chances of getting pregnant and giving birth to term, although it does carry an increased risk of miscarriage and premature birth. It also requires a cesarean section.

Cryopreservation of ovarian and testicular tissues. This procedure, while still experimental, involves surgically removing tissue and then freezing it and ideally re-implanting it after cancer treatments are completed.

If these options are not available, donor cells, including eggs, embryos, and sperm, may be considered. If a woman’s uterus is healthy enough for conception and her hormone stores are strong enough to carry the baby to term, surrogacy may be another option. Women may also consider foster care or adoption. If you think you might still want children, start a conversation with your doctor as soon as possible and bring up any fertility issues. Many cancer centers such as Cancer Centers of America ^® (CTCA) have oncology services with experienced doctors who can advise you on a fertility preservation method tailored to your needs.