Lifestyle shifts, late marriages, lack of awareness have often increased the chances of fertility issues in India and the prevalence of breast cancer was there forever. However, it has recently taken the limelight irrespective of the age group, and more women are gradually being aware of it with chances of early detection. Nonetheless, our society still requires to know about the correlation between fertility & cancer treatments. According to Dr. Y. Swapna, Fertility Consultant, Nova IVF Fertility, Vijayawada, it is quite important to talk to your cancer care team to know how a cancer surgery or treatment can have a lasting effect on your fertility before having the surgery or starting treatment.
What can cause fertility problems?
When a person cannot have a child after repetitive attempts are termed as infertile. For women, infertility can mean they are not able to get pregnant through normal sexual intercourse or facing problems carrying a baby throughout the pregnancy.
Problems with fertility can also be called reproductive problems or alterations. They happen when certain hormone levels are abnormally low or high or if sex organs are removed or aren't functioning properly. There are quite a lot of physicals issues that might cause and trigger fertility issues. Scarcity of healthy eggs, sex hormone disruptions, tubal blockages or any other pressing issue that can cause infertility are amongst the many other situations.
How Cancer can affect fertility?
In many cases, cancer surgery or treatments can be more likely than cancer itself to interfere with some parts of the reproductive process and affect the ability to conceive. Diverse surgery kinds and treatments can have different effects and the risk of infertility varies depending on:
- The patient’s age and stage of development; for example, before or after puberty, before or after menopause, etc.
- The type and extent of surgery
- The type of treatment given (radiation therapy, chemotherapy, hormone therapy, targeted therapy, immunotherapy, stem cell transplant)
- The dose of treatment
Recommendations for preserving fertility
All women with cancer should be aware of the risk of infertility and fertility preservation options with their fertility experts as soon as possible before cancer treatment begins. In this case, preserving is the next logical step is preserving fertility, even if one is unsure whether she wants to have children in the future.
The options are dependent on several factors:
- Relationship status, such as having a partner who could provide sperm
- Physical and sexual maturity
- Personal preferences and feelings about different procedures
Here are a few recommendations for preserving fertility that will help women in their journey towards motherhood even after having cancer.
This is the most successful way of fertility preservation. It is also called in vitro fertilization. Embryo freezing is a procedure that allows people to store embryos frozen for later use.
Oocyte (unfertilized egg) freezing
A person can also freeze unfertilized eggs. This procedure is similar to embryo freezing, but the eggs are frozen without being fertilized by sperm. This is an option for women without a male partner to provide sperm.
Ovarian tissue preservation
This method involves surgically removing and freezing ovarian tissues. The surgeon can transplant the tissue after cancer treatment. This may be the only option for young girls who cannot undergo oocyte or embryo freezing as some girls may lack the time or sexual maturity.
Surgery for ovarian cancer
In the case of ovarian cancer, surgeons can remove only one ovary. It is an option for some women with early-stage cancer located in a single ovary. This preserves the healthy ovary for reproduction and prevents early menopause.
Radiation therapy that protects the ovaries
There is a possibility that some women may receive radiation to only one ovary and this preserves fertility. Another option is a procedure called an oophoropexy, where a surgeon moves one or both ovaries where the radiation will not reach them. Then, the surgeon puts them back in place after treatment. However, this method is not always successful. Radiation is not precise and may still reach the ovaries or the ovarian blood supply.
During cancer treatment, patients have important and complex issues to consider, including present and future fertility as many cancer treatments can damage future fertility. Therefore, patients who are or will be at a childbearing age (or parents of children with cancer) should ask their cancer care team about the possible impact treatment might have on their fertility so they can discuss their options. Here, keeping in view all the possible options, embryo freezing is the most simple and effective way to enjoy motherhood even after going for cancer treatment. This is high time, people are aware of this method can initiate their parenthood journey without any mental limitations.
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