Preserving Fertility Before Treatment
Natural conception may be possible after cancer treatment, but some treatments may make it difficult or even impossible for patients to have children after treatment is complete.
Cancer-related fertility challenges can have several possible causes:
- Surgery on the reproductive organs can prevent patients from conceiving.
- Cancer-fighting drugs like chemotherapy, targeted therapy and immunotherapy can stop the reproductive system from working normally.
- Radiation therapy to or near the reproductive system or to the head, where the glands that control some reproductive hormones are located, can impact the patient’s ability to have children.
Fertility preservation for cancer patients
Since every patient is different, it may be difficult to predict how treatment will impact your ability to have children. Patients who may want to have children should talk to an oncofertility specialist about ways to preserve their fertility. Some fertility preservation methods are available to pediatric patients as well as adults.
Preserving fertility in females
Fertility preservation methods for females include:
Egg freezing: The patient takes hormones to stimulate the ovaries to grow multiple follicles that contain eggs. The eggs are removed from the patient and immediately frozen and stored.
Embryo freezing: patient takes hormones to stimulate the ovaries to grow multiple follicles that contain eggs. The eggs are removed from the patient and fertilized in a laboratory with the sperm of a partner or donor. The resulting embryos are then frozen and stored.
Ovarian tissue freezing: Prior to treatment, all or part of an ovary is removed, cut into small pieces and frozen. Each piece contains hundreds of unripe eggs. After treatment, the tissue can be placed back in the body.
Ovarian suppression: The patient is given drugs to stop the ovary from growing follicles. Doctors believe inactive ovaries may sustain less damage from cancer treatment. This method is still being studied.
Learn more about fertility options for females with cancer.
Preserving fertility in males
Methods to preserve male fertility include:
Sperm banking: The patient’s sperm is frozen and can later be used for fertility treatments.
Testicular freezing: A small piece of a testicle is removed and frozen before treatment begins. Currently, this is experimental in males that have not gone through puberty. Scientists are researching ways to transplant the tissue back into the body and to help mature sperm cells develop from the tissue.
Learn more about fertility options for males with cancer.
Fertility recovery after cancer treatment
Some cancer patients who experience infertility after treatment may have their fertility return on its own. The chances of fertility returning are influenced by factors like age, diagnosis and the treatments received.
There is no way to know for sure when or if fertility will return, however. It can happen shortly after treatment or years later.
For females, the return of menstruation may or may not be a sign that their fertility has returned. Blood tests for hormones and other tests performed by a fertility specialist may give a better answer.
Males often have low sperm counts or motility (movement) at the time of their cancer diagnosis. While these may improve after treatment, medical help may still be needed to conceive. A semen analysis can indicate whether a pregnancy is likely through intercourse or if fertility treatment may be needed.
Before getting pregnant, females who have had cancer treatment should consult a maternal-fetal medicine (MFM) specialist to discuss pregnancy risk and how the pregnancy should be managed. MFMs are OB-GYNs with special training in caring for high-risk pregnancies.
Questions to Ask Your Doctor
If you want to have children after cancer treatment, discuss the issue with your doctor as soon as possible. You also may want to talk to a counselor familiar with cancer and fertility to help you with decision making.
For people who have recently been diagnosed or are in treatment
- What can I do before treatment to increase the likelihood that I will be able to have children?
- Is freezing eggs or embryos an option for me? Could you please give me more information?
- Is sperm banking an option for me? Could you please give me more information?
- I stopped having my period, but could I still get pregnant? Should I be using birth control?
- Will my cancer treatment cause me to be infertile? Do you expect this to be temporary or permanent?
For people who have completed treatment
- Now that my cancer treatment has ended, I would like to have children. Can we try to become pregnant?
- We have been trying to get pregnant without success. Should we talk to a fertility specialist?
Featured Podcast:
Cancer treatment and fertility preservation: When to talk to your doctor
Oncofertility specialist: Don’t let cancer keep you from building a family
As a reproductive endocrinologist and infertility specialist at MD Anderson, I bridge oncology and reproductive medicine to expand family-building options for cancer patients.
About 10% of people diagnosed with cancer are of reproductive age. My goal is for them to have the option to undergo fertility preservation before starting cancer treatment. I also want to discuss their family-building options after they’ve completed cancer treatment.
I believe that a cancer diagnosis should not keep you from having the family you’ve always wanted.
Why oncofertility is important in cancer care
I spent many years caring for fertility patients – that is, people who seek medical treatment in hopes of conceiving a child. And I found that many of my patients had been impacted by cancer. I wanted to do all that I could to help them. That led me to specialize in oncofertility; I now focus strictly on reproductive options for people with cancer.
There is much that is still unknown about the reproductive impact of many cancer therapies. So, my research focuses on exploring the treatment-related impacts and providing better counseling for people preparing to undergo cancer treatment. I want to learn more about how treatment can impact their future fertility and help us improve fertility preservation options.
The good news is that most people treated for cancer will become long-term survivors. A big part of their survivorship is the desire to have children in the future. I’m passionate about expanding their options and talking to patients about how to protect their fertility before they start treatment.
For me, it’s personal
My family knows firsthand how important oncofertility is. My husband is a cancer survivor, and he was initially treated at MD Anderson almost 30 years ago. We have three wonderful children, largely due to fertility preservation.
I’ve seen the type of care MD Anderson provides to its patients. It’s unsurpassed. My husband is doing so well largely because of the commitment and effort of his physicians who cared for him and continue to care for him today. And now we have a beautiful family.
Because of that outstanding care he received, I knew I wanted to work at MD Anderson. Now, as a faculty member, I’m able to give back by providing my patients the same quality care my husband received. It’s truly rewarding.
Patients are our No. 1 focus
I love working at MD Anderson because our patients are at the heart of everything we do. We view it as our passion, not a job. We want the very best for every patient we see, and we care for them as though they are members of our own families.
Cancer treatment isn’t just about the physical aspects of undergoing therapy. For so many of the young patients I care for, future fertility and having a family are extremely important. So, if we focus solely on their cancer treatment and ignore these other important aspects of their care, we are not doing the best we can for our patients.
At MD Anderson, we focus on the entirety of the patient’s care and what’s important to them. That’s one way we’re able to sustain long-term relationships with patients. We have patients who stay in touch with us 10, 20, 30 years down the road. They send us photos of their families, including milestones in their children’s lives. And we love celebrating those successes with them. There is nothing more rewarding than seeing patients live the lives they were always intended to have.
As I tell every patient: a cancer diagnosis does not define you nor does it limit you in terms of what you see for yourself and your future family.
Laurie McKenzie, M.D., is a reproductive endocrinologist and infertility specialist at MD Anderson.
Request an appointment at MD Anderson online or call 1-877-632-6789.