How Young People With Cancer Can Preserve Fertility

Young people who receive a cancer diagnosis face many challenges, including concerns about whether they’ll be able to have children after treatment. Fortunately, a variety of options exist to help make family planning a reality for young cancer patients. .

How Cancer Affects Fertility

Every year in the U.S., roughly 16,000 children and 80,000 young adults age 20–39 are diagnosed with cancer. While survival rates for these age groups are high, fertility is a concern for many younger cancer patients or their parents.

Cancer treatments like surgery, chemotherapy, radiation therapy and hormone therapy can all affect a person’s ability to have children. In some cases, surgery removes the testicles, uterus or ovaries. More commonly, sperm and eggs are damaged by chemotherapy and radiation treatment, which can be harmful to fertility in the future.

Options for Men

Also called sperm cryopreservation, sperm banking is a simple and inexpensive process that collects and freezes sperm for future use. “In an ideal world, every male would take advantage of sperm banking before getting cancer treatment,” says University Hospitals Urology Institute  urologist, Nannan Thirumavalavan, MD.

“If a patient changes his mind later on and decides not to use his stored sperm to father a child, there’s no harm done,” says Dr. Thirumavalavan. “But the opposite may be a different story: If you opt not to save your sperm and change your mind later, unfortunately there will be no stored sperm available.”

Some men don’t have enough sperm production or require cancer treatment immediately. Another option for preserving male fertility is testicular sperm extraction (TESE), which extracts sperm cells directly from the testicle and freezes them for future use. Certain types of cancer, such as lymphoma, leukemia, and testicular cancer, can themselves cause low sperm production before treatment begins, making sperm preservation even more valuable.

Options for Women

The most common method for preserving fertility in women is egg freezing, also known as oocyte cryopreservation. In this process, a woman takes hormones to help the ovaries develop a group of mature eggs, which are harvested, frozen and stored for future use. Egg freezing typically takes 3– 4 weeks and can be fast-tracked to avoid delaying a potentially life-saving cancer treatment.

“Egg freezing is not an option for prepubescent girls,” says Katie Coyne, MD , an obstetrician-gynecologist with the UH Fertility Center  who specializes in reproductive endocrinology and infertility. “Instead, we can use ovarian tissue freezing for girls at this age, surgically removing a single ovary and freezing it for future use.”

In this procedure, an ovary is surgically removed and frozen. If or when a woman is ready to have a child, the ovary (or part of the ovary) is implanted back into the body.

Options for Creating Embryos

For young cancer patients who are ready to start a family or add to their family, in vitro fertilization is combined with embryo freezing. A woman’s eggs are harvested and fertilized with sperm, and embryos are frozen for later use. These procedures can be performed with sperm or eggs from a partner or a donor.

Preserving Fertility During Treatment

A variety of measures can be used during cancer treatment to protect fertility. “Protective methods we employ during treatment include moving the ovaries (or the testicles) outside of the field of radiation therapy exposure,” says Dr. Coyne.

Another approach for protecting female fertility uses hormones – specifically, gonadotropin-releasing hormone agonists – to suppress ovary function before chemotherapy to help protect the ovaries from chemotherapy-related side effects and damage.

Building Awareness About Oncofertility

“With a new cancer diagnosis, so much is going on in the initial appointments to discuss treatment planning, that addressing fertility issues often gets overlooked,” says Kate Daunov MSN, AOCNP, an Oncofertility and Young Adult Oncology Specialist at UH Seidman Cancer Center and UH Rainbow Babies & Children’s Hospital.

Daunov is the first point of contact for young adults who are diagnosed with cancer and have fertility a concerns. Working with Dr. Thirumavalavan and Dr. Coyne, she coordinates sperm banking for male patients, and discusses egg retrieval and ovarian tissue freezing with female patients. She follows them through their cancer care journey to make sure their fertility needs are met.

The number of young cancer patients who discuss fertility preservation before beginning cancer treatment is still relatively low. Daunov hopes that eventually all young patients facing a cancer diagnosis will be equipped with the tools they need to preserve their fertility and support their dreams of having a family.

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At the University Hospitals Fertility Center, our team of highly skilled fertility specialists provides advanced infertility treatments for even the most complex cases, including patients undergoing cancer treatment.