Certain cancers and their treatment can affect fertility in males and females, and if a cancer survivor wants to have children after their treatment ends, then planning ahead is necessary. Certain types of cancer surgeries can result in the removal of organs needed for pregnancy, and certain treatments might change hormone levels or cause damage to a female’s eggs. These effects result in some women losing their fertility during treatment that can be either temporary or permanent. Some women may choose to take steps that might help preserve their fertility so they can try to have children after their treatment.
It is best that discussions about preserving fertility take place before cancer surgery happens or before treatment begins. Don’t assume the doctor or nurse will ask the patient if fertility is important to them. They don’t always remember to bring this up, so the patient may have to advocate for themself. If a woman is considering taking steps to preserve her fertility, and it is possible to do so, then she should be sure to understand the risks and chances of success of any fertility option that she is interested in. Keep in mind that no method works 100% of the time. Referrals to counseling should be made for women who may be anxious or distressed about fertility-related effects. Egg or embryo freezing is recommended to help preserve fertility for females with cancer, and it is important to find a fertility specialist and center that has the best experience in these procedures.
Egg freezing is a good choice for women who do not have a partner, do not want to use donor sperm to make a fertilized embryo, or if they have a religious conflict with freezing a fertilized embryo. The process of collecting eggs takes 2 weeks depending on where a woman is in her menstrual cycle. Injectable hormone medications are given for approximately 10 days, and the procedure is done at an outpatient surgical center, with a needle attached to a vaginal ultrasound under anesthesia. A laboratory process called vitrification has greatly improved the success of egg freezing, so when a woman is ready to try to become pregnant, the eggs can then be thawed, fertilized by a partner’s or donor sperm, and implanted in her uterus to try to achieve pregnancy. Many cancer survivors have been able to return to do an IVF cycle with their frozen eggs and have a child with their own genetic tissue.
A woman’s age and menopausal status play a large role in the chances of pregnancy, with a younger age at the time of egg freezing resulting in a higher potential for a successful pregnancy. The quality of the future embryos also makes a difference.
Costs vary for these procedures from center to center, and some insurance companies may cover the expenses. The Livestrong Foundation offers financial support for patients who do not have coverage. The cost can be $10,000 or more, which may or may not include the annual storage fees. If a cancer patient has frozen eggs, embryos, or sperm, it is important to stay in contact with the cryopreservation facility to be sure that any yearly storage fees are paid and the address is updated.