Have you been diagnosed with cancer and are getting ready to start treatment? If you are in your fertile years, or if you have a child who needs treatment, it’s important to understand if and how you can retain the ability to have a family.
What is oncofertility?
Oncofertility is a field of medical research and practice that combines oncology, which deals with the prevention, diagnosis and treatment of cancer, and reproductive medicine. The aim of oncofertility is to treat cancer while preserving a patient’s fertility, keeping options open for reproduction in the future.
How does cancer and cancer treatment affect fertility?
Some types of cancer, such as uterine, ovarian, and testicular cancers directly impact your ability to have children by causing damage to the reproductive organs. However, treatment for many different kinds of cancer can harm a person’s fertility as well.
Chemotherapy can damage a woman’s eggs, but the extent of that damage greatly depends upon the drug and the dosage used, according to the American Cancer Society. Similarly, chemotherapy can affect male fertility by slowing or stopping sperm production, which also depends on the drug and dosage used. A man’s age can also play a role in determining whether or not sperm production will be able to return after chemotherapy. While boys and young men who have undergone chemotherapy may be able to produce sperm again over time, men over 40 may not recover the ability to produce sperm at all.
Radiation treatment can also affect fertility. Even if the treatment is not directly aimed at the ovaries, uterus, or testicles, the radiation may bounce around inside your body and harm reproductive organs. Little is known about the effects of targeted and biologic (immune) therapies on the reproductive systems, however bone marrow or stem cell transplants almost always impact fertility in both men and women. These therapies require high doses of chemotherapy and may also require radiation treatment.
When should you talk to your healthcare team about your fertility?
If you are in your fertile years or you have a child who needs cancer treatment, talk to the care team before treatment begins. You have a right to know how the treatment may affect your fertility, or your child’s ability to have a family in the future if they are the patient, and what steps can be taken to keep those options open. You may want to speak to a reproductive endocrinologist, who is a fertility expert, about ways you can protect your fertility before treatment and how you can have a family after treatment if your reproductive organs are damaged. Some reproductive endocrinologists have extensive experience with fertility preservation and can work with you and your oncologist before treatment if time permits.
What can I do if I’ve already been treated for cancer?
Many people may overlook fertility when overwhelmed with facing cancer treatment, especially if the type of cancer doesn’t seem to directly impact reproductive organs. If you have already been treated for cancer and are struggling to conceive, consulting a reproductive endocrinologist will help you explore your options for having a family. These may include testicular sperm extraction (TSE), donor sperm, donor eggs, and IVF. Adoption may be another option to consider, but while most adoption agencies do not rule out cancer survivors, they may require a letter from your doctor stating that you are cancer-free and can expect to have a normal, healthy lifespan, according to the American Cancer Society.