Fertility preservation in cancer patients

Fertility preservation in cancer patients

Cancer treatments such as chemotherapy, radiotherapy and surgeries can affect fertility in both men and women.
All cancer patients should be counselled regarding preservation of fertility before starting any treatment in order to have the ability to have children in the future.

The effects of cancer on fertility depends on the following:
-    Type of cancer
-    Age of patient
-    Type of cancer treatment
-    Dose of treatment
-    Duration of therapy
-    Location of cancer

1-    Fertility preservation for women include:
-    Egg freezing
-    Embryo freezing
-    Ovarian tissue freezing
-    Ovarian suppression

** egg freezing:
-    The most commonly used method
-    Ovaries are stimulated with hormones after which eggs are collected and frozen for future use
-    Used for married and unmarried women
-    Its disadvantage is that hormonal treatment might not be suitable in certain cancers and the ovarian stimulation takes time which might delay initiation of cancer therapy

** embryo freezing:
-    Higher success rate
-    Used for married women

** ovarian tissue freezing:
-    Ovarian cortex removed surgically, frozen and reimplanted after finishing cancer treatment
-    It doesn’t need hormonal stimulation which might be helpful in certain cancers

** ovarian suppression:
-    Suppression of ovaries might help protect its function during chemotherapy
-    Reduces ovarian damage
-    Doesn’t guarantee fertility preservation
-    Should be used with other more reliable methods

2-    Fertility preservation for men:
-    Sperm freezing
-    Testicular tissue freezing

** sperm freezing:
-    Requires puberty (sperm production)
-    Non invasive
-    High success rate

** testicular tissue freezing:
-    Used for prepubertal boys
-    Still experimental 
-    Invasive and requires local/general anesthetic

All cancer patients of all age groups should be referred to fertility specialists before initiation of treatment to improve chances of future parenthood.

Dr Najeeb Layyous  F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist