Having children after cancer: These are some fertility treatment options

Going through chemotherapy may affect your fertility, but that doesn't mean that there's no way you can conceive. Here are fertility treatment options for cancer patients.
cervical cancer
Cervical cancer increase your risk of infertility. Image Courtesy; Adobe Stock
Dr Meghana Vinay Nyapathi Updated: 13 Jan 2023, 16:21 pm IST
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A cancer diagnosis can be devastating as it wreaks havoc on someone’s life by affecting a person’s physical, psychological and financial state. Not many are aware that cancer and its treatment like radiation, and chemotherapy also affect the fertility of both men and women. Advanced fertility treatment options like fertility preservation come as a ray of hope in keeping one’s fertility intact and enabling cancer patients to build their families in the future at their convenience. Awareness about the possibility of parenthood, even after cancer, is the need of the hour.

How does cancer impact fertility?

The disease itself can cause changes in the body by disrupting hormones needed for ovulation, and pressure affects the reproductive organs, thereby reducing fertility.

Cancer and infertility
Does cancer treatment lead to infertility? Image Courtesy: Shutterstock

Some of the common factors that could affect the infertility of cancer patients:

1. Cancer surgery

If ovaries, uterus, or testicles are removed as part of treatment, it can affect one’s ability to conceive.

2. Radiation

Depending on the dose, duration, and site of the radiation, one can even lose eggs in the ovaries leading to premature ovarian failure or sperms from the testes, causing Azoospermia.

3. Chemotherapy

Many drugs used in chemotherapy are harmful to the gonads and alkylating agents, such as Cyclophosphamide, top the list. These drugs can destroy the oocytes and deplete the follicular pool in women. It can lead to the reduction of sperm or germ cells in men, leading to decreased fertility.

Cancer and its treatment can also lead to menstrual disturbances in females and sexual dysfunction in males further affecting the chances of a successful conception.

4. Age

Advancing age at diagnosis and treatment increases the risk of gonadal damage due to chemotherapy and radiation.

Fertility treatments that may help cancer patients conceive

Fertility preservation is a process through which eggs, sperms, embryos, and ovarian or testicular tissue are cryopreserved (stored in liquid nitrogen at an extremely low temperature of -196 degrees C) for future use. When cancer treatment is completed, and the male or female or the couple is ready for pregnancy, the frozen eggs/sperm/embryos can be thawed, and IVF can be done to achieve pregnancy.

fertility and cancer
Fertility treatment options for people going through cancer. Image Courtesy: Shutterstock

Types of fertility preservation

Here are the type of fertility preservation that may be a boon for cancer patients who want to conceive:

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1. Embryo cryopreservation

Here, mature eggs are retrieved from women with or without ovarian stimulation and fertilized with sperm through IVF. The embryo formed after fertilization is frozen. When the cancer treatment gets over, and the woman is ready for pregnancy, the frozen embryo is thawed and implanted in the woman’s uterus to enable her in achieving motherhood. This method has the best chance of achieving pregnancy.

Also Read: IVF is an effective and safe procedure to treat infertility

2. Sperm freezing

For men who have cancer, sperm can be retrieved before the treatment begins and frozen for later use. In prepubertal boys, testicular tissue can be frozen, implanted later, and sperm extracted for use in Assisted Reproductive Technologies.

3. Oocyte cryopreservation

This can be done during any time of the cycle, depending upon the time available between diagnosis and the start of cancer treatment. Other factors like the patient’s age, time of the menstrual cycle, and type of cancer are considered when planning the protocol. If possible, hormone injections are given to increase the number of developing follicles in the ovaries after which the eggs are retrieved from the women before cancer treatment and are frozen. The frozen eggs can be thawed and fertilized with sperm when she desires to get pregnant.

4. Ovarian tissue cryopreservation

Here, a part or entire ovary is removed and frozen. This is useful in prepubertal girls and also in women where ovarian stimulation is not possible due to various reasons. After the treatment is completed and when the woman is ready for pregnancy, the ovarian tissue is re-implanted into the pelvic cavity or a heterotopic site. This procedure also has the advantage of helping patients get back their normal reproductive endocrine function, as seen in almost 90 per cent of cases as noted in a study. This tissue starts functioning, and the eggs so produced by this transplanted tissue can be collected and used for fertilization.

Cancer need not take away one’s dream of becoming a parent! Taking the right decision after a cancer diagnosis is of paramount importance that could save one’s reproductive potential for the future.

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About the Author

Dr Meghana Vinay Nyapathi is a clinical head and fertility specialist at Oasis Fertility, HSR in Bengaluru. She is a reproductive medicine specialist who is well-versed in the management of all aspects of infertility like polycystic ovarian syndrome, poor ovarian reserve, endometrial pathology, fertility preservation, and male infertility. Her areas of special interest include the management of women with polycystic ovarian syndrome and endometrial pathology.Dr. Meghana completed her MBBS from Dr. BR Ambedkar Medical College, Bangalore and went on to complete her Master of Surgery in Obstetrics and Gynaecology (MS-OBG), from Sri Devaraj URS Medical College (SDUMC), Kolar. She obtained her Fellowship in Reproductive Medicine from CIMAR, Cochin and is a Certified Indian Menopause Practitioner (CIMP). ...Read More

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