Cancer and Your Fertility | Oncofertility Atlanta
Technology now allows many cancer patients to preserve their fertility. With the vast improvement in long term survival prognoses, optimizing the chance for future childbearing can make cancer treatments more bearable. At ACRM, we specialize in oncofertility and encourage all patients with a new cancer diagnosis to meet with our dedicated oncofertility team to understand the available fertility preservation options.
Cancer Treatment Risks
Diminished ovarian reserve
One of the possible side effects of cancer treatment is diminished ovarian reserve (DOR), or simply put, a loss of eggs at a faster-than-expected pace. Having a low egg reserve can make conception much more challenging and can limit the ability to undergo some fertility treatments like in vitro fertilization (IVF). Chemotherapy is one of the best known causes of DOR. Radiation to the pelvis can also cause DOR.
Different chemotherapy regimens have different risks for causing DOR. Older women are more likely to be affected by DOR than are younger women. DOR may present as irregular menstrual cycles, or the cessation of cycles, hot flashes, and/or vaginal dryness. The most extreme form of DOR is premature menopause.
Premature menopause occurs when a woman has run out of almost her entire supply of eggs. This can be caused by chemotherapy treatment or pelvic radiation. Symptoms of premature menopause include the absence of menstrual cycles, hot flashes and vaginal dryness.
Pelvic radiation can cause scarring within the uterine cavity, making embryo implantation more challenging. Surgery may be required to correct the scarring. Severe cases may not respond to surgery and a gestational carrier may be needed to carry the pregnancy.
Hysterectomy may occur when cancer affects the cervix or uterus. If hysterectomy occurs, a gestational carrier would be required to carry the pregnancy. Embryos would be created via IVF and then transferred to the gestational carrier.
Fertility Preservation Options
Egg freezing is an option for any female who has reached puberty and is at risk of running out of eggs prematurely after cancer therapy. In the egg freezing process, a patient's ovaries are stimulated with hormone shots to produce multiple mature eggs at one time. The eggs are “retrieved” during a simple, outpatient procedure performed under light sedation. The eggs can then be frozen (“vitrified”) and saved until the patient is ready to use them. Current data suggests that frozen-thawed eggs work just as well, especially in patients < 35 years old, as fresh eggs. The process of egg freezing requires 2-6 weeks and can be coordinated with a patient's cancer treatment schedule.
For male patients diagnosed with cancer, there is the option of freezing sperm. Certain chemotherapy can compromise a man's sperm production, rendering him sterile in some cases. Freezing sperm is an easy and effective process that has been performed for many years. Frozen sperm can then be used in the future in combination with intrauterine insemination or IVF.
Embryo freezing is an option typically chosen by women who are in a committed, long-term relationship. Embryo freezing entails ovarian stimulation with hormone shots, retrieval of the eggs and then insemination of those eggs with the partner's (or donor) sperm. In this way, embryos are created, then frozen until the couple is ready to use them.
In cases where a patient has already been through cancer treatment and has experienced premature menopause or severe DOR, donor eggs can be used to create a successful pregnancy. These donor eggs, which have been screened extensively by ACRM, can be combined with sperm to create embryos. One of these embryos can then be transferred into the patient's uterus, resulting in very high pregnancy rates.
For patients who are unable to carry a pregnancy, either due to damage or removal of the uterus, or because of concerns regarding medical complications or the risk of stimulating regrowth of a previous cancer, a gestational carrier (GC) may be used. GCs are women who have previously carried pregnancies without complications. Embryos, created from the intended parents' eggs and sperm, can be transferred to the GC. This is a very effective and safe method of having a child when a patient can not carry a pregnancy herself.
Financial Assistance for Fertility Preservation
ACRM is pleased to offer oncofertility services at a discounted rate. Additionally, we work with pharmacies and programs to help defray the cost of oncofertility medications needed by our patients.
Oncofertility New Patient Appointment
To schedule a priority appointment, please contact ACRM at 678-841-1089 or 877-767-2276 and select the option to be connected to a new patient scheduler. You can also request an appointment online. Indicate that you are a cancer patient so that we may schedule an appointment for you as soon as possible.
Watch ACRM's Dr. Lisa Hasty discuss fertility treatment options for cancer patients: