Overview
Men and women diagnosed with cancer who wish to conceive at some stage in the future may need to consider techniques to preserve their fertility as some forms of cancer therapy can affect their fertility.
For couples in this situation, it is important to consider involving a fertility specialist prior to commencing cancer treatment. This will maximise the chance of success.
Q. How will cancer treatment affect my fertility?
How cancer treatment will affect your fertility depends on the type of cancer diagnosed and the type of treatment recommended.
Surgery:
During surgery to remove cancer tumours, it may also be necessary to remove the ovaries and/or uterus and fallopian tubes. This is particularly in the case of gynaecological cancers, such as cancer of the cervix or ovaries.
Chemotherapy:
Chemotherapy acts on rapidly dividing cancer cells to destroy them. However, chemotherapy also poses a risk to a woman’s fertility by damaging her eggs, resulting in infertility. The risk of infertility resulting from chemotherapy is related to the patient’s age, the specific chemotherapeutic agents used, the dose administered, and the length of time the drugs are used.
Radiotherapy:
Radiotherapy is like chemotherapy in that while acting to destroy rapidly dividing cancer cells, it can also act on healthy cells. When radiotherapy is conducted on the pelvic region, it can bring on an early menopause.
Q. What options does fertility preservation offer?
Cryopreservation of sperm has been a routine procedure since the early 1980s for men prior to treatment for malignant diseases, and thousands of babies have been born to couples where the male is an infertile survivor of cancer treatment.
For women, the options are more complicated. There are several options available to women, however, each has its own limitations. Freezing mature oocytes (eggs) is currently the most promising treatment. Further investigation into egg freezing techniques is also a key project within IVFAustralia’s Research & Development program.
The fertility preservation options will depend on the woman’s:
- Age
- Type of cancer treatment
- Type of cancer diagnosed
- Level of desire to have a future family
- Partner status
- Time available prior to the start of cancer treatment
- Possibility that cancer has metastasised to the ovaries
Some options that your fertility specialist may discuss with you are:
- Doing a rapid IVF cycle to store embryos (taking 2 – 3 weeks)
- Freezing mature oocytes (eggs)
- Ovarian Cortex Cryopreservation
Freezing Mature Oocytes (eggs)
Recent research into egg freezing is so far very promising. At IVFAustralia, we are currently carrying out research on the Cryotop technique for freezing eggs. This involves very rapid freezing in a tiny amount (less than 0.1 microlitres) of a special vitrification solution, before storing in liquid nitrogen. This process prevents ice crystals forming, which damage the cellular infrastructure of the egg and is one of the current problems with freezing eggs.
The current standard for freezing sperm and embryos is based on a slow freeze and quick thaw technique, called cryopreservation. Cryopreservation of sperm has been a routine procedure since the early 1980s for men prior to treatment for malignant diseases, such as cancer. While thousands of babies have been born to couples where the male is an infertile survivor of cancer treatment, the technique when applied to eggs has a very low success rate. This is due to the large percentage of fluid in an egg, which does not allow the egg to cope with the thawing process.
Egg freezing is currently only offered to specific groups of patients such as those undergoing cancer therapy, but it may in the future be offered more widely to different groups such as single women.