Fertility Options
Each patient is unique. The impact of a given treatment on fertility can vary and so can the time available before starting life saving treatments. Patient age, marital status, personal wishes, religious and cultural constraints and prognosis may all affect decision making. Fertility preservation treatments must be tailored to the individual circumstances and integrated with the treatment regimen. Close coordination between the treating physician and the reproductive endocrinologist is the key to preserving family-building options for your patients.
For more information, read the following options for women, men, and children or call the Oncofertility Consortium’s Patient Navigator for Fertility Preservation, (517) 884-6434 or oncofert@msu.edu.
Women:
Embryo banking
During this process, a woman’s ovaries are first stimulated to mature multiple eggs, which are then removed and fertilized through in vitro fertilization (IVF) with sperm to create embryos. The embryos are then frozen for future use. The entire process can take up to one month.
Egg banking
This is a new technology that is starting to show good results and, according to the American Society for Reproductive Medicine, is no longer considered experimental. This process is exactly the same as described for embryo banking except that the eggs are NOT fertilized before freezing. This is a good option for single women who do not have a male partner and do not want to use donor sperm.
Ovarian tissue banking
One entire ovary is removed surgically and the outer surface (cortex) which contains the eggs is frozen in strips for later use. Women who are survivors of some types of cancer can have pieces of the tissue thawed and transplanted back. A number of pregnancies have resulted from using this technique. Transplant is not safe following some types of cancer (e.g. leukemia) because of the risk of re-seeding the original cancer. The Oncofertility Consortium is actively researching new ways to use this tissue. New techniques are still experimental but may be the best option for woman who must start their treatments immediately.
Ovarian transposition
Surgeons can move the ovaries away from the area receiving radiation therapy. The goal of the surgery is to move the ovaries within the pelvis where they can still function, but will be out of the way of harmful radiation. This technique will not protect against the effects of chemotherapy.
The procedures listed above have varying risks and side effects. Some options may not be recommended for certain types of cancer or disease. There may also be treatments available that have a smaller risk of infertility. It is important to discuss these procedures with your physician and your insurance provider since they may be expensive and not covered by insurance.
SaveMyFertility.org
Learn more about the fertility and hormonal risks of cancer and treatment options for women at SaveMyFertility.org.
Men:
Sperm banking
Sperm cells are collected and frozen for future use. Read more information about sperm banking.
Gonadal Shielding
Gonadal shielding can be used to protect the testes from scatter radiation. Read more information about Gonadal Shielding.
Testicular Sperm Extraction (TESE)
For adolescents or adult patients that are not able to produce a semen sample, testicular sperm extraction (TESE) is a surgical approach to retrieve sperm from a testicular biopsy.
Testicular tissue cryopreservation
Testicular tissue, including cells that produce sperm and sperm itself, is removed and frozen. Read more information about testicular tissue cryopreservation.
The procedures listed above have varying risks and side effects. Some options may not be recommended for certain types of cancer or disease. There may also be treatments available that have a smaller risk of infertility. It is important to discuss these procedures with your physician and your insurance provider since they may be expensive and not covered by insurance.
Children/Adolescents:
Egg banking
Young women are stimulated with fertility drugs to cause them to produce a number of eggs. The eggs are retrieved surgically and frozen for future use. This technique is still considered experimental, takes about a month to complete and requires multiple vaginal ultrasounds and a vaginal egg retrieval. Not all adolescents and their families will be comfortable with this procedure.
Ovarian tissue freezing
One entire ovary is removed surgically, the outer surface (cortex) which contains the eggs is removed and frozen in strips. Women who are survivors of some types of cancer can have pieces of the tissue thawed and transplanted back. A number of pregnancies have resulted from using this technique. Transplant is not safe following some types of cancer (e.g. leukemia) because of the risk of re-seeding the original cancer. The Oncofertility Consortium is actively researching new ways to use this tissue. New techniques are still experimental but may be the best option for woman who must start their treatments immediately.
Sperm banking
Sperm cells are collected and frozen for future use. Read more information about sperm banking.
Testicular tissue cryopreservation
Testicular tissue, including cells that produce sperm and sperm itself, is removed and frozen. Read more information here.
The procedures listed above have varying risks and side effects. Some options may not be recommended for certain types of cancer or disease. There may also be treatments available that have a smaller risk of infertility. It is important to discuss these procedures with your physician and your insurance provider since they may be expensive and not covered by insurance.
SaveMyFertility.org
Learn more about the fertility risks of cancer and treatment options for children at SaveMyFertility.org.
Third party reproduction:
There are other parenthood options that are available to individuals who may not be able to conceive or carry their own biological children. These include:
Donor eggs, sperm, and embryos
Eggs, sperm, or embryos provided by a known or anonymous donor.
Surrogacy
Having another woman carry your child.
Adoption
The Oncofertility Consortium has compiled a list of adoption agencies that would like to work with cancer survivors.