Preserving fertility during cancer treatment

If you’re facing cancer treatment and would like to have children once your treatment ends, you will likely need to do some planning around fertility preservation. Fertility preservation is when eggs, sperm, or reproductive tissue are saved or protected so that a person can use them to have children in the future. You can have those discussions and make plans with your oncologist before any cancer surgery happens or any treatments begin.

Preserving Fertility

Possible natural pregnancy

In females who were fertile before treatment, the body may recover naturally after treatment. It may be able to keep or restore normal hormonal cycles. and produce mature eggs that can be fertilized and implanted into the uterus to become a fetus. The medical team may recommend waiting anywhere from 6 months to 2 years before trying to get pregnant.

  • Patients may have a tumor that directly damages an organ or its surrounding tissue.
  • Cancerous organs that normally would be needed to have a child, like the testicles, penis, ovaries, uterus, or cervix, may need to be removed.
  • Certain treatments for cancer can change hormone levels, trigger early menopause, damage nerves, or make certain sex organs stop working properly.
  • Psychological or emotional responses, such as stress and anxiety may also affect fertility.

Options for preserving fertility

Experts recommend freezing embryos or eggs, called cryopreservation, to help preserve fertility for certain females with cancer. It's important to find a fertility specialist and center that has experience in these procedures. The process of collecting eggs for embryo and egg freezing are the same. However, the timing can be different. Collecting eggs for embryo cryopreservation typically takes several days or weeks, depending on where a woman is in her menstrual cycle. Injectable hormone medications are given for females when they are safe to give. For egg cryopreservation, the time of the menstrual cycle is not as important.

Options for preserving fertility

Experts recommend freezing embryos or eggs, called cryopreservation, to help preserve fertility for certain females with cancer. It's important to find a fertility specialist and center that has experience in these procedures. The process of collecting eggs for embryo and egg freezing are the same. However, the timing can be different. Collecting eggs for embryo cryopreservation typically takes several days or weeks, depending on where a woman is in her menstrual cycle. Injectable hormone medications are given for females when they are safe to give. For egg cryopreservation, the time of the menstrual cycle is not as important.

Embryo freezing

Embryo freezing, or embryo cryopreservation, is an effective way to help preserve fertility for females. Mature eggs are removed from the female and put in a sterile lab dish with several thousand sperm. The goal is for one of the sperm to then fertilize the egg. This is called in vitro fertilization (IVF). In vitro intracytoplasmic sperm injection (IVF-ICSI) involves taking a single sperm and injecting it directly into an egg to fertilize it. In both IVF and IVF-ICSI, the lab dish is observed and if the egg is fertilized, the embryo can be frozen.

Egg (oocyte) freezing

Egg freezing (or oocyte cryopreservation) is also an effective way to help preserve fertility for women, although it has not been used as long as embryo freezing (described above). This may be a good choice for women who do not have a partner, do not want to use donor sperm to make a fertilized embryo, or if they have a religious conflict with freezing a fertilized embryo.

Ovarian tissue freezing

This procedure is still experimental. It involves all or part of one ovary being removed by laparoscopy (a minor surgery where a thin, flexible tube is passed through a small cut near the navel to reach and look into the pelvis). The ovarian tissue is usually cut into small strips, frozen, and stored. After cancer treatment, the ovarian tissue can be thawed and placed in the pelvis (transplanted). Once the transplanted tissue starts to function again, the eggs can be collected and attempts to fertilize them can be done in the lab.

Men and boys with cancer have a number of options to preserve their fertility during treatment.

Further information

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