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Fertility Preservation Options, Procedures and Protocols

Fertility preservation services are expanding as advances in cancer treatment are made, allowing people to live longer and fuller lives. As a result, quality-of-life issues including fertility preservation, are a concern for more and more cancer patients within their reproductive years.  In a new article in Reproductive Biomedicine Online by oncofertility researchers Nicole Noyes, MD, Jaime M. Knopman, MD, Katherine Meizer, MD, M. Elizabeth Fino, MD, Brooke Friedman, MD and Lynn M. Westphal, MD, entitled, “Oocyte Cryopreservation as a Fertility Preservation Measure for Cancer Patients,” the authors discuss the various fertility preservation procedures, options, and stimulation protocols available to female cancer patients.

One particular cancer, cervical cancer, is commonly diagnosed during the reproductive years. Historically, the treatment for cervical cancer was a radical hysterectomy, meaning the surgical removal of the uterus, ovaries, oviducts, cervix and related lymph nodes making it impossible for a female to conceive or carry a child.  The radical hysterectomy is often followed by pelvic radiation and chemotherapy depending on what stage the disease is in at diagnosis. As a result of the average age and reproductive potential of women diagnosed with cervical cancer, an alternative treatment for early stage cervical cancer was implemented: the radical trachelectomy.

A radical trachelectomy is the surgical removal of the uterine cervix. As the uterus is preserved, this type of surgery is a fertility preserving surgical alternative and is applicable in selected younger women with early cervical cancer.  According to the authors, “it is estimated that up to half the patients diagnosed in their child-bearing years are eligible for this procedure,” and data suggests that survival is similar to that of a radical hysterectomy. As you may remember from a previous blog, Michelle Whitlock opted for this procedure when she was first diagnosed with cervical cancer in an attempt to preserve her fertility.

Undergoing a radical trachelectomy does not ensure that conception and birth can be achieved. The authors discuss complications that can arise from radical trachelectomy such as cervical-factor infertility, premature delivery, and late-term miscarriage. They also suggest that patients who pursue IVF, opt for a single embryo transfer to lessen their chance of twins and/or miscarriage. To learn more about this procedure as well as other fertility sparing procedures, options, and protocols for women, please click here to read, “Oocyte Cryopreservation as a fertility Preservation Measure for Cancer Patients.”

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