Cancer & Fertility Preservation

The field of oncofertility, which merges oncology and reproductive medicine, has grown in its ability to preserve the reproductive future of men, women and children facing a cancer diagnosis.

Our approach to oncofertility involves a collaborative effort between our team of reproductive endocrinologists, the Women & Infants cancer care team, as well as a host of other specialists in our area.

We also work in tandem with on-site psychologists and social workers that help guide patients toward their specific treatment plan.

Female cancer patients wanting to have children someday may consider one of the following methods to give themselves the best chance of building a family.

• Embryo freezing is the most established technique to preserve a woman’s fertility, according to the American Society for Reproductive Medicine (ASRM). During this process, patients undergo IVF, which first includes extracting a woman’s eggs. The eggs are then mixed in the laboratory with either a partner’s sperm or donor sperm and, if successful, the resulting embryo is frozen and stored.
• Egg freezing, which is similar to embryo freezing, and involves extracting and cryopreserving unfertilized eggs for future use in IVF.
• Gonadal shielding places shields in the woman’s pelvic area to protect reproductive organs from radiation exposure. This technique is not used with chemotherapy, as that may damage the organs even with shields in place.
• Ovarian transposition surgically repositions the ovaries as far away from the radiation field as possible. This procedure is used when radiation is used on the pelvis without chemotherapy.
• Ovarian tissue cryopreservation is also an option for prepubescent girls who haven’t yet ovulated. An oncofertility surgeon removes the ovarian tissue and cryopreserves it. After the cancer treatment and the return to good health of the girl, the ovarian tissue is implanted near the fallopian tube where it may possibly produce eggs in the future. This remains an experimental procedure.
• Use of suppressive medications such as Lupron which prevent active egg development in the ovary. This approach remains somewhat controversial but is widely used.

These fertility preserving techniques are generally used in cases of non-aggressive cancers. Ovarian tissue cryopreservation is classified by ASRM as an experimental procedure, though a promising one, and several live births using the procedure have been reported.

Oncofertility specialists may use it for women who can’t use other fertility preservation techniques. It is also an option for women who can’t delay the start of their cancer treatment to undergo egg retrieval.