We at the Oncofertility Consortium spend much of our time developing new techniques and options for young cancer patients who wish to preserve their fertility before undergoing cancer therapy. But what options are available to cancer survivors who did not undergo fertility-sparing treatments?
Cancer patients may not protect their reproductive potential before beginning cancer treatment for many reasons including an immediate need for care, unavailable options near a patient’s home, and young age at cancer diagnosis, among others. Once they successfully beat cancer and start thinking about the future, young people may begin to wonder about their reproductive options. Since tailored treatments are used to combat each distinct case of cancer, fertility is also differently affected in every case. Treatments that may affect fertility include surgery, radiation, and chemotherapy. Even the doses, locations, and combinations of these treatments may affect later reproductive ability. Finally, these variables can alter the fertility of individual cancer fighters in different ways.
Survivors who wonder about the impact of cancer treatment on their reproductive potential should talk with a physician or fertility counselor. Survivors with additional questions or need for referrals can contact the FERTline oncofertility patient navigators. Analysis of a man’s semen sample can determine if the number and mobility of sperm indicates diminished fertility. Women may have their ovaries, fallopian tubes, and uterus examined and their hormone levels measured. Though these tests may give an indication of fertility, there is no sure-fire way to determine person’s reproductive potential until he or she attempts to conceive a child.
Cancer survivors who find their fertility impaired may use one of the many options in assisted reproductive technology (ART) to have biological children. Men with reduced sperm count or mobility may undergo intrauterine insemination or intracytoplasmic sperm injection, which involves depositing sperm into the uterus or injected into an egg, respectively, to increase the chance of conceiving. Male or female cancer survivors can also fertilize their sperm or eggs through in vitro fertilization (IVF) to have a child.
Survivors who lose reproductive ability after cancer and its treatment can employ third party reproduction to have children. These include using donor sperm, eggs, or embryos to have a child. Women whose bodies are unable to support a pregnancy to term can also employ a surrogate, or gestational carrier, to carry the survivor’s biological children or with the use of donor gametes. Adoption is also an option that is becoming increasingly available to cancer survivors, in part, due to some of the research at the Oncofertility Consortium. Thus, cancer patients who did not undergo fertility preservation should not lose hope as they still have the ability to build a family.