Fertility Preservation – Assurance of Parenthood for Cancer Survivors

When an adult or a teenager is detected with cancer, the parents are under a whirlwind of emotions and despair. Why their child? This question haunts them every day. What looms over is the worry of their child’s future to lead a normal life, to be able to have a family life. For young adults, their future ambitions and dreams to have a life partner and children seem to be jeopardised. However, modern science has now reached a step ahead of curative procedures to ensure that the cancer survivors can rehabilitate back to normal life. This is possible through Fertility Preservation 

What is fertility preservation?

This is a process of saving eggs, sperm or reproductive tissue from a person so that he or she can use it to bear biological children in future.  It is an effort to help cancer survivors retain their ability to procreate. The parents of child or adult patient are focused on the treatment and hence may not be aware that such an option exists. In the case of teenagers or elder children, parents sometimes are not comfortable discussing fertility and prospect of children in future. Understanding the options for fertility preservation and taking the right guidance can assure a better quality of life for the cancer survivors.

How does cancer affect fertility?

When a person is diagnosed with cancer, it is important to understand the nature of treatment, the intensity and its impact on fertility. Chemotherapy and radiations tend to damage sperms in males. In females, high-intensity radiations and strong medicines can affect the eggs, hormones or the ovaries and uterus. The effect of cancer treatment depends on the nature and level of cancer. Some treatment might involve removal of uterus and/or ovaries in females or testis in males. The treatment can harm the fertility or render the patient temporarily or permanently sterile. Women at times cease to ovulate for a few months post-treatment.

Options for preservation

The advancement in this field has provided a number of options.

Options for Men

  • Sperm cryopreservation – Semen samples from the man are frozen and stored. The process is called cryopreservation.
  • Gonadal shielding – Radiation treatment for cancer has an effect on the area of treatment and also the other organs in the body. Modern technology allows doctors to either aim the radiation in the designated area or a lead shield is used to protect the testicles.

Options for Females

  • Embryo cryopreservation – Also known as embryo freezing, it is the widely used option for preserving fertility. First, the eggs are removed from the ovaries and then fertilized with the sperm from partner or donor by IVF Gangaram. The subsequently formed embryos are frozen and stored.
  • Oocyte cryopreservation – Similar to embryo cryopreservation, but here unfertilized eggs are frozen and stored in cases where the male partner is not available.
  • Gonadal shielding – Similar to the shielding for males, the radiations are aimed at the spot of treatment and the pelvic area is covered with a lead shield, to protect the ovaries.
  • Ovarian transposition – If the area of treatment lies close to the ovaries, the doctors perform a surgery to move the ovaries to a slightly safer zone where it is not affected by the radiotherapy

Ovarian tissue banking or testicular tissue banking is also used for children who have not hit puberty. (This technique is still in experimental stages

 

When is it done?

Post diagnosis of cancer the doctor will formulate a treatment plan. Once it is done the doctor has to assess the fertility risk of the treatment. It is imperative that the doctor should communicate the treatment procedure and its impact and means to preserve fertility to the patient or to the parents in case of minors. If the patient or the parents are willing to preserve, a reproductive specialist is referred for further process.