The best time to preserve your fertility is before cancer treatment starts. If you are facing a cancer diagnosis and want to have children in the future, the experts at Emory Reproductive Center offer several options that can help reduce the impact cancer has on your ability to have a child.

How does cancer treatment affect fertility?

Women are born with all the eggs they will ever have. They cannot grow or make new eggs. Chemotherapy, radiation therapy, and some surgeries can harm or destroy the eggs or cause other fertility problems.

Often, chemotherapy or radiation therapy can stop your periods for a while (called amenorrhea) or make them irregular. Your periods may continue or return after treatment, but having periods does not always mean that you are fertile. In some cases periods may never return.

Chemotherapy or radiation therapy can cause infertility right away or years later by causing you to go into menopause early.

Your cancer treatment may affect your ability to carry a pregnancy. For instance, high-dose radiation to the pelvic region can raise the risk of a future miscarriage or cause premature birth. Women who have had a hysterectomy (surgery that removes the uterus) cannot carry a child.

What is my chance of infertility?

Not everyone becomes infertile after cancer treatment. The impact that cancer treatment may have on your fertility depends on many factors, including:

  • The type of cancer and stage
  • Type and total dose of chemotherapy
  • Location and dose of radiation therapy
  • Location of surgery
  • Your age at the time of treatment
  • Your baseline fertility before you start treatment

Fertility Preserving Options for Women

Ideally, most fertility-preserving procedures need to be done before your cancer treatment begins. The options available to you depend on several factors, including:

  • Age
  • Relationship status, such as whether you have a partner who could provide sperm
  • How physically and sexually mature you are
  • Your feelings about specific procedures

Our experts can help you explore options to preserve your fertility which may include:

Embryo freezing is the most successful method of fertility preservation for women. For this option, you will take fertility drugs for about two weeks. Then, your eggs are collected and fertilized by sperm in a laboratory. This is called in vitro fertilization. The resulting embryos are frozen until you are ready to become pregnant. Although fertility drugs increase estrogen, drugs called aromatase inhibitors can keep the levels low if you have an estrogen-sensitive cancer.

This procedure is similar to embryo freezing, except that the eggs are frozen without being fertilized by sperm. This procedure may pose fewer practical issues than freezing embryos because a male partner is not needed. However, it is slightly less successful.

Some types of surgery for cervical or ovarian cancer can treat the cancer and help you keep your fertility.

If you have surgery to remove your cervix while keeping your uterus, you may become pregnant. Then you can deliver the baby by Cesarean section. This may be an option if you have early-stage cervical cancer.

Some women with early-stage ovarian cancer in only one ovary can have surgery to remove that ovary. If this is the type surgery you have, you will still have one healthy ovary and uterus.

Radiation treatment to both ovaries causes infertility. You may be able to get radiation to only one ovary to preserve your fertility. Another option is a procedure called oophoropexy. In this procedure, one or both of your ovaries are moved where radiation treatment won’t reach them. Then, they are returned after treatment. This method isn’t always successful. Radiation isn’t precise and may reach the ovaries or the ovarian blood supply, even if they are moved.

This investigational procedure involves taking hormones that suppress ovarian function to protect eggs from treatment. The procedure’s effectiveness has not yet been shown and is generally not recommended as a reliable method of fertility preservation.

This investigational procedure requires the surgical removal and freezing of ovarian tissue. Then, this tissue is transplanted back into your body after your cancer treatment is complete. This may be the only option for young girls who cannot undergo oocyte or embryo freezing because of lack of time or sexual immaturity. Even though many pregnancies have occurred with this technique, it is too early to evaluate its success rates.

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