fertility preservation for female cancer patients

Don’t Let Cancer Hinder Fertility in Women. Know Your Options

Cancer is the most dangerous problems anyone can face. The most common cancers in girls and young women are Hodgkin or non-Hodgkin lymphoma, leukaemia, thyroid cancer, breast cancer, melanoma, or gynecologic cancers (cervix, uterus, or ovary). Most of these cancers can be treated with chemotherapy, radiation, or a combination of both. Chemotherapy and radiotherapy have paved the way for successful cancer treatments and are indispensable components of cancer care. Some Chemotherapeutic agents and Radiotherapy (pelvic radiation therapy or total body irradiation) given at higher doses and longer duration of treatment can increase the risk of infertility.

When women are diagnosed with cancer, a plethora of emotions arise and there are so many decisions to make. Young women diagnosed with cancer today have a greater chance of long-term survival than ever before. Advanced technology has left a number of options to remove and freeze eggs, fertilized eggs(embryos) or ovarian tissue before treating cancer. With these options, women are able to become pregnant even after the cancer treatment. This process is called cryopreservation or freezing.

Embryo cryopreservation

Embryo cryopreservation is the most common way of preserving the ability to get pregnant in the future. Then women can undergo a procedure called in vitro fertilization (IVF). In IVF, you will be given hormones to stimulate the ovaries to produce a number of eggs. Once they are developed, the eggs will be removed by gentle suction. Embryos are created in the laboratory by joining together the sperm and the egg. The fertilized eggs or embryos are then frozen. You may even choose to perform genetic testing on the embryos prior to freezing them (called PGD or preimplantation genetic diagnosis). PGD may be used to test for a specific genetic disorder (for instance, to check for the BRCA gene in a woman with breast cancer).

Not everyone can have this procedure. You’ll have to take medications that make you produce more eggs than usual. In total, the process may take 2 to 3 weeks to complete. Unfortunately, if you need chemotherapy or radiation treatment for your cancer, you may not be able to wait that long. The medications that make your body produce more eggs may also make your body produce more hormones, such as estrogen. Estrogen can make some cancers worse.

Embryo cryopreservation offers the best chance of pregnancy. If you decide to use embryo cryopreservation, you will need to have a man’s sperm to fertilize your egg before it is frozen. If you are unmarried, then egg freezing is a good option.

Egg (oocyte) cryopreservation

Women may choose this option over embryo cryopreservation if they have no current male partner or for personal/religious reasons. Procedures for freezing eggs have improved greatly over the past 10 years, making this a good option for many women. Despite the success of egg freezing, pregnancy rates are still higher per embryo frozen than per egg frozen. This is because by the time an embryo is frozen it has already been fertilized and grown for several days, showing its reproductive potential. This process still involves IVF and usually requires 2 to 3 weeks. You will take medications that will help you grow many eggs. However, after eggs are removed from your body, they are frozen immediately. Unlike embryo cryopreservation, the eggs are not fertilized before they are frozen. After your cancer treatment, eggs that survive the freeze-thaw process will then be fertilized in the laboratory with your husband’s sperm. Embryos that develop will be placed in your uterus.

Ovarian Transposition

Ovarian transposition is a surgery that moves your ovaries out of the field of radiation. This will lower the amount of radiation your ovaries are exposed to during your radiation therapy. It may also help your ovaries keep working properly after your treatment. If your ovaries are working properly, you have a better chance of having children after your cancer treatment.

In adults, the ovaries and fallopian tubes have to be separated from the uterus to move them far enough away. In children, the ovaries and fallopian tubes can usually be moved out of the field of radiation without having to separate them from the uterus.

Even if you have an ovarian transposition, your ovaries will still be exposed to some radiation. This can affect your chances of having biological children, especially if you’re also getting chemotherapy.  If you might want to get pregnant in the future, you will need to see a reproductive endocrinologist.

Ovarian tissue cryopreservation

Doctors have been experimenting with a procedure to freeze the tissue that contains resting eggs from a woman’s ovary. In this procedure, doctors cut the tissue from one of your ovaries into thin slices. These slices are then frozen.

After your cancer treatment, the doctors can place a slice of thawed ovarian tissue back into your body. You may need to be treated with fertility hormones for this tissue to produce an egg. There are some disadvantages to this procedure. You will have to have surgery several times. It also is dangerous if you have cancer of the ovary. If the tissue has cancer and is placed back in your body, cancer could spread. It is important for you to know that ovarian tissue cryopreservation is still an experimental procedure. It has not always been successful at all fertility centres, and the success rate is very low.

You should consult a doctor before taking any actions. At Aaradhya, we use a rapid freezing method called “Vitrification” which helps freeze/thaw oocytes/embryos successfully over the years. You can call us on 88865 92229 and preserve your options.

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