Preserving fertility for patients commencing cancer treatment
(This article was published in GPH news Spring 2009)
When treatment for cancer, with either chemotherapy or radiotherapy, is planned the oncologist will discuss the side effects of the treatment with their patient.
For patients who are treated for cancer during their reproductive years this can include damage to the reproductive system, which may result in infertility.
At Greenslopes Private Hospital our fertility experts at Assisted Conception Australia work closely with our oncologists to assist patients who may need to consider their fertility options after diagnosis. It is important that this consultation is done as soon as possible so that the opportunity for fertility preservation is given every chance for successAccording to fertility expert, Dr Clare Boothroyd, “There is now clear evidence that survivors of cancer in reproductive years are pleased to be alive but their greatest source of dissatisfaction is their loss of fertility and their belief that options for their preservation of their fertility were not discussed with them at the time of their treatment.
“This places a huge onus on oncologists to address these issues at a stressful time. At GPH because of our close liaison with the oncologists fertility preservation consultation can be streamlined to the busy schedule a patient can have prior to commencement of treatment and all the services can be conducted on site.”
“Sometimes cancer can be diagnosed when couples are actively trying to conceive and it is wonderful to have the privilege of helping them create new life as well as seeing them through their cancer treatment. This is because patients are told that they should avoid conceiving a pregnancy whilst having chemotherapy,” Dr Boothroyd said.
For men they need to consider there may be damage to part of the testis where sperm are made and chemotherapy and radiotherapy to the testes can reduce a man’s sperm production permanently. If a man is considering having a family in the future it is important to consider freezing semen before treatment is started.
For women, there may be damage to the eggs in the ovary and chemotherapy and radiotherapy can damage a woman’s eggs permanently, resulting in difficulty conceiving a pregnancy and early menopause. Early menopause can also result in loss of periods and low levels of the female hormones, oestrogen and progesterone.
There are four possible ways for women who are about to undertake chemotherapy to try to preserve their fertility:
1. Undertake an in vitro fertilisation (IVF) cycle and create embryos, which can be frozen.
2. Undertake an IVF cycle and freeze eggs.
3. Have a laparoscopy and freeze part of the ovary where the eggs are.
4. Reduce egg production during chemotherapy, using a drug such as:
Syneral™, Lucrin™ or Zoladex™.