Q. When I was diagnosed, my cancer was aggressive and treatment needed to start as soon as possible. So when asked about fertility, I didn't get a chance to review all my options or come up with the money to get it done. I had a partial hysterectomy (my ovaries were removed but my uterus is still there). I was wondering what would be my options for children in the future?
When you are diagnosed with cancer you are faced with many immediate decisions to make, it is extremely overwhelming. It is challenging to process the news of your diagnosis, especially when you have been notified that treatment needs to begin right away. Unfortunately, fertility is not always an immediate conversation or something an individual may automatically think about when beginning cancer treatment. It may not feel or seem like a priority in that moment. Fortunately, the topic of fertility is gaining increasing awareness for both men and women. More and more doctors are having these conversations prior to cancer treatment. And, there are many wonderful organizations that support fertility options—physically, emotionally, and even financially.
In general, fertility preservation is the process of saving or protecting eggs, sperm, or reproductive tissue so that a person can use them to have biological children in the future. It may be time sensitive and could also be necessary to explore prior to cancer treatment. However, everyone’s situation is different and there are many factors to be considered. Therefore, it is important to speak to your medical team to further discuss what your options may be. You may also want to make an appointment with a fertility specialist to gain additional information throughout this process. As medical advancements continue, doctors and patients may become aware of more options. Today, there are many ways to have children and it is important to determine what may be the best fit for you.
The following resources may also be helpful to explore:
- The National Cancer Institute - Fertility
- Fertility Preservation
- Livestrong Fertility
- Fertile Action
- Fertility Within Reach
Fertility issues can be stressful and complex. If you would like to further discuss this topic and how to address it before, during, and after treatment you may be interested in calling CancerCare’s Hopeline to speak to an oncology social worker.
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Answers From Other Experts About Cancer and Fertility
I finished treatment and would like information on fertility issues and cancer survivors. Can you help me?
Unfortunately, one potential effect of cancer and cancer treatment is the loss of fertility in both men and women. Depending on cancer type and treatment methods, your age, and other factors, your fertility may be compromised on a temporary or permanent basis. To determine this likelihood and possible solutions, it is important that you talk to your oncologist and a fertility specialist. The American Cancer Society has comprehensive information on the main causes and options for cancer-related infertility for women and for men. For women, causes include:
- damage to your eggs caused by certain kinds of chemotherapy
- damage to your ovaries caused by radiation
- removal of the uterus (hysterectomy) or ovaries (oophorectomy)
- hormonal treatments
If you have a uterus and ovaries, you may still be able to get pregnant. Some medical professionals recommend waiting 6 months before trying, to avoid fertilization of damaged eggs. A doctor specializing in high-risk obstetrics can check that your ovaries are still functioning and that your heart and lungs are strong enough to withstand pregnancy. If you were not able to freeze embryos (cryopreservation) before beginning cancer treatment but you still have your uterus, you may consider:
- getting implanted with donor eggs through IVF (in-vitro fertilization)
- getting implanted with a donor embryo through IVF
For men, infertility may be caused by:
- damage to your sperm cells caused by chemotherapy
- damage to sperm cells caused by radiation
- surgery to remove your testicles or prostate
- hormonal therapies
Some men recover their ability to produce sperm after cancer treatment (maybe a year or later). If you did not freeze your sperm before treatment but you can still produce sperm, you may consider:
- getting your semen analyzed to determine the level of DNA damage to your sperm
LIVESTRONG provides information on fertility options at all stages of cancer treatment to help you make an informed decision based on your individual needs. You can also find information to help deal with the financial, practical and legal aspects of infertility.