Fertility issues for people facing cancer treatment

Infertility is one possible side effect of cancer treatment that younger people and their doctors may not take into consideration during their initial focus on battlinga cancer. But it is an important issue, and it’s becoming more so as both the chances of cure and the methods for preserving fertility grow. For those reasons, the American Society of Clinical Oncology (ASCO) has put together guidelines to raise awareness among both doctors and people with cancer of the options that may be available for preserving their fertility.

A frank discussion

The ASCO guidelines suggest that cancer doctors (oncologists) review with men and women during their first discussions of cancer treatment the possibility of temporary or permanent infertility. The risk of infertility is affected not only by the type and dose of therapy a person receives but also by his or her age, particular cancer, and current fertility status.

When appropriate, a person should be referred to a specialist who can assist with fertility preservation. The doctor specialist can also offer advice about whether a preservation method alters the effectiveness of cancer treatment. The ASCO guidelines list the cancer treatments most likely to result in infertility (e.g., certain types of chemotherapy and radiation therapy) as well as the various approaches to preserving fertility and the evidence for their success.

Individualized treatment

For men, collecting and then freezing sperm is an effective method of preserving fertility. It should be done before cancer therapy begins. When radiation is the risk factor, the testicles may be shielded from x-rays. This strategy requires special expertise.

Freezing embryos is an established technique for women, but it is primarily for those who have a partner. (Eggs are fertilized in a lab dish, and then the embryo that develops is frozen.)

Freezing eggs is a relatively new approach. It also requires special timing, which may be difficult to coordinate with a cancer treatment plan. Shielding the ovaries from radiation may be a possibility. In addition, new surgical techniques may help women preserve their fertility.

For children who have not yet reached puberty, the options are minimal. One experimental approach is to freeze tissue from the ovaries or testicles. The hope is that fertility might be restored when this tissue is later implanted back into the body.

The ASCO guidelines note that when it comes to preserving fertility, each situation calls for a different approach.The good news is that new techniques are being investigated all the time.

From the American Society of Clinical Oncology