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How Cancer Treatment Affects Fertility

on Feb 27, 2020

Cancer treatments can hurt your chances of healthy conception post-treatment. Taking steps before your treatment begins can help preserve your future fertility. 

Discovering you have cancer is an extremely stressful and frightening experience. Unfortunately, another factor to consider in the diagnosis is that some cancer treatments can have a significant negative impact on patients’ fertility, adding an extra layer of worry for those who hope to have children. Luckily, modern developments mean that there are options available to help preserve your ability to conceive — as long as you take action before the treatments begin.

How Do Cancer Treatments Affect Fertility? 

Different cancer treatments have varying degrees of impact on fertility for both men and women. In some cases, the effects of treatment can be temporary, but other treatments have permanent effects. That’s why it’s important to ask your doctors about the potential risks of your cancer treatment to your fertility and, if you hope to have children, to begin taking steps to preserve your fertility before treatments begin. 

Many factors determine how cancer treatment will affect your fertility. These include the type of treatment you’re getting, the type and stage of cancer you have, your current fertility status, and your age (the younger you are when you undergo treatment, the greater the chances are that you may become fertile again post-treatment). Some of the cancer treatments that will impact fertility are: 

  • Surgery: The removal of the uterus, ovaries, or testicles will all harm fertility. 
  • Chemotherapy: Different drugs and dosages have varying levels of impact on fertility, but it is common for chemotherapy to cause a reduction in fertility. 
  • Radiation: Radiation can be one of the more damaging treatments, depending on the dose and on the radiation field. Radiation poses more of a risk to fertility if the pelvis is being targeted in treatment.
  • Other cancer treatments like hormone therapies can affect fertility, but the effects are usually reversible and fertility is often restored once treatment stops.

If you have recently been diagnosed with cancer and are interested in having a child in the future, you should immediately ask your doctor about what your treatment plan means for your fertility. Studies have suggested that women with cancer are less likely to be given information about preserving their fertility than men. Unmarried women or women with at least one child are even less likely to be told, so it is critical that you initiate these conversations with your medical team if you hope to conceive. Once you understand the potential adverse effects of your treatment, you should reach out to a fertility specialist to help you navigate the best preservation option for you. 

Fertility Preservation Options

Fortunately, modern medicine and technology means that there are now options available for preserving fertility in the face of cancer treatments. For men, the best option is sperm cryopreservation — essentially sperm freezing. This process involves collecting and freezing sperm that can later be thawed and used to fertilize eggs. While this can be done through a sperm bank, working with a fertility specialist ensures that higher quantities will be stored to improve your future chances of successful in-vitro fertilization (IVF). 

The sperm freezing process can begin as early as the day you are diagnosed. The sperm can be recollected every 48-72 hours, and fertility specialists recommend that men freeze their sperm on 2-3 separate occasions before beginning cancer treatment. Men can also preserve their fertility through radiation shielding, which involves putting small lead shields over the testicles during treatment to reduce the amount of radiation exposure they receive. This can be done for women as well by putting shields over the ovaries. 

For women, there are a few options available for preserving fertility. The best options are achieved with the help of Assisted Reproductive Technologies (ART), and they involve freezing either embryos or unfertilized eggs. Freezing embryos, or embryo cryopreservation, involves harvesting eggs from the woman’s ovaries, fertilizing them, and then freezing the fertilized eggs so that they can be implanted later. The fertilized eggs can be implanted either into the woman following her cancer treatment, or into a surrogate. Roughly 90% of embryos survive this process of freezing and thawing. 

Egg freezing has a slightly lower success rate than embryo freezing, but is another good method for preserving female fertility. This method works similarly to embryo freezing, with the exception of fertilization — no sperm is required for egg freezing. Another method of fertility preservation that is specifically intended for women being treated with radiation to the pelvis or abdomen is ovarian transposition, which is a process in which the ovaries are surgically repositioned. Surgery can help shift the ovaries within the uterus so that they are not in the radiation field. However, this method still leaves the risk of the woman ending up infertile due to scattered rays that may hit the repositioned uterus. 

Preserving Your Fertility for the Future

Finding out that you or your partner has cancer is obviously an incredibly stressful and frightening time in your life — ensuring you take the proper steps to preserve your fertility before treatment can help remove one potential stressor. We at Advanced Fertility Center of Texas (AFCT) want to do everything possible to help you focus on your health and well-being during this time.

If you or your partner has recently been diagnosed with cancer, schedule an appointment with a fertility specialist at AFCT. We can help you navigate this stage of your life so that you can improve your fertility outcomes post-treatment.

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