Cancer and cancer treatments can impact reproductive health, making it
difficult or impossible to have a child in the future. Thanks to advancements
in technology, we offer treatment before your cancer treatment to preserve
fertility and keep your options for childbearing open.
Cancer Treatment Risks
Diminished Ovarian Reserve
One of the possible side effects of cancer treatment is diminished ovarian
reserve (DOR). This condition results in a loss of eggs at a faster-than-expected
pace. Having a low egg reserve can make conception much more challenging
and can limit the ability to undergo some fertility treatments like
In Vitro Fertilization (IVF). Chemotherapy and radiation therapy in the pelvic region are common causes of DOR.
Different chemotherapy regimens have different risks for causing DOR. Older
women are more likely to be affected by DOR than are younger women. DOR
may present as irregular menstrual cycles or the cessation of cycles,
hot flashes, and/or vaginal dryness. The most extreme form of DOR is premature
menopause.
Premature Menopause
Premature menopause occurs when a woman has almost run out of her entire
supply of eggs before the age of 40. In cancer patients, this can be caused
by chemotherapy treatment or pelvic radiation. Symptoms of premature menopause
include the absence of menstrual cycles, hot flashes, and vaginal dryness.
Uterine Scarring
Pelvic radiation can cause scarring within the uterine cavity, making embryo
implantation more challenging. Surgery may be required to correct the
scarring. Severe cases may not respond to surgery and a gestational carrier
may be needed to carry the pregnancy.
Hysterectomy may occur when cancer affects the cervix or uterus. If hysterectomy
occurs, a gestational carrier would be required to carry the pregnancy.
Embryos would be created via IVF and then transferred to the gestational carrier.
Fertility Preservation Options
Egg Freezing
Egg freezing is an option for any female who has reached puberty and is at risk of
running out of eggs prematurely after cancer therapy. In the egg freezing
process, a patient's ovaries are stimulated with hormone shots to produce
multiple mature eggs at one time. The eggs are “retrieved”
during a simple, outpatient procedure performed under light sedation.
The eggs can then be frozen (“vitrified”) and saved until
the patient is ready to use them.
Current data suggests that frozen-thawed eggs work just as well, especially
in patients < 35 years old, as fresh eggs. The process of egg freezing
requires 2-6 weeks and can be coordinated with a patient's cancer treatment schedule.
Embryo Freezing
Embryo freezing is an option typically chosen by women who are in a committed,
long-term relationship. Embryo freezing requires ovarian stimulation with
hormone shots, retrieval of the eggs and then insemination of those eggs
with the partner's (or donor) sperm. In this way, embryos are created,
then frozen until the couple is ready to use them.
Donor Eggs
In cases where a patient has already been through cancer treatment and
has experienced premature menopause or severe DOR, donor eggs can be used
to create a successful pregnancy. These
donor eggs, which have been screened extensively by ACRM, can be combined with sperm
to create embryos. One of these embryos can then be transferred into the
patient's uterus, resulting in very high pregnancy rates.
Gestational Carrier
For patients who are unable to carry a pregnancy, either due to damage
or removal of the uterus, concerns regarding medical complications, or
fear of stimulating regrowth of a previous cancer, a
gestational carrier (GC) may be used. GCs are women who have previously carried pregnancies without
complications. Embryos, created from the intended parents' eggs and sperm,
can be transferred to the GC. This is a very effective and safe method
of having a child when a patient cannot carry a pregnancy herself.
Financial Assistance for Fertility Preservation
ACRM is pleased to offer oncofertility services at a discounted rate. Additionally,
we work with pharmacies and programs to reduce the cost of oncofertility
medications needed by our patients.
To schedule a priority appointment, please contact ACRM at
678.841.1089 or email
scheduling@acrm.com. You can also
request an appointment online. Be sure to let us know if you are a cancer patient so that we can prioritize
your appointment.
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