For many young cancer patients in India, the battle against the disease comes with an added challenge, preserving fertility. Aggressive treatments like chemotherapy, radiation, or surgery are often essential for survival but can have severe repercussions on reproductive health. Hodgkin's lymphoma, thyroid cancer, testicular cancer, melanoma, sarcomas, and leukaemia are some cancers that predominantly affect young adults and require treatments that may lead to temporary or permanent infertility.
To understand fertility preservation in cancer patients, OnlyMyHealth team interacted with Dr Kaushik De, Manager, Growth Advisory at Aranca.
“A cancer diagnosis brings immense challenges, and for young patients in India, the potential impact on fertility adds another layer of complexity. Many patients are now discussing their options with healthcare providers before beginning treatment, empowering themselves to safeguard their reproductive potential and maintain control over their future amidst the uncertainties of cancer therapy,” says Dr Kaushik.
The Impact of Cancer Treatments on Fertility
The extent to which cancer treatments affect fertility depends on various factors, including the type, intensity, and duration of treatment. According to Dr Kaushik, “Chemotherapy, particularly with alkylating agents, can damage eggs in women and sperm in men, potentially causing irreversible infertility. Radiation near the pelvic area or brain may harm reproductive tissues or disrupt hormonal balance, while surgeries involving the removal of reproductive organs completely eliminate fertility potential.”
Timely discussions about fertility preservation significantly improve the chances of success, ensuring young patients retain the option of building a family in the future.
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Fertility Preservation Options for Women
Women have several options to preserve fertility, depending on the urgency of their treatment:
- Egg and Embryo Freezing: A widely available method in India, this involves stimulating the ovaries to retrieve eggs, which are frozen either unfertilised or fertilised to create embryos.
- Ovarian Tissue Freezing: This method is suitable for those who cannot delay cancer treatment. The ovarian tissue is frozen and reimplanted later. Though less common in India, it remains a promising alternative.
- Ovarian Suppression: Hormonal treatments can protect ovarian function during chemotherapy, reducing ovarian damage. This is often combined with other methods.
- Emerging Techniques: In vitro maturation (IVM) and other experimental approaches are being explored, offering hope for the future.
Fertility Preservation Options for Men
Preserving fertility is simpler for men, with widely available methods such as:
- Sperm Banking: The most common approach, sperm is collected and frozen for future use.
- Testicular Sperm Extraction (TESE): For men unable to provide a sperm sample, this method retrieves sperm directly from the testes.
Also read: Expert Explains The Emotional Toll Of Male Infertility And How To Offer Mental Support
Barriers to Fertility Preservation in India
Despite advancements, several barriers limit access to fertility preservation in India:
Lack of Awareness: Many patients and healthcare providers fail to prioritise discussions about fertility before treatment.
Financial Constraints: Procedures like egg freezing or sperm banking cost INR 50,000 to INR 2,00,000, often unaffordable for families already burdened by cancer treatment expenses.
Socio-Cultural Taboos: Conversations about reproductive health are often restricted, particularly in rural areas.
Geographic Disparities: Fertility preservation services are primarily available in urban centres, making access challenging for rural patients.
Emotional Stress: The emotional toll of a cancer diagnosis often leads patients to prioritise survival over fertility preservation.
The Way Forward
Dr Kaushik emphasises, “Addressing these challenges requires increasing awareness, improving accessibility, and providing comprehensive emotional support to patients.” Public campaigns, healthcare workshops, and insurance coverage for fertility preservation can significantly improve access. Expanding services to smaller cities and offering subsidised rates will help bridge the gap.
Fertility preservation allows young cancer patients to dream of a future that includes the possibility of parenthood. With growing awareness, technological advancements, and proactive measures, India can ensure that cancer survivors embrace life beyond their diagnosis with hope and resilience.