3 April 2020

How cancer treatment affects fertility in women

Girl hugging mother
Doctor
Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London

 

In our era of ever-improving treatments for cancer and higher survival rates, there are more and more people who can look forward to a cancer-clear future. As a result, many are now able to think about how cancer treatment itself may affect their future. This includes their chances of having a family.

There are many different types of cancer treatment. The most well-known are radiotherapy and chemotherapy. These both carry the possibility of damaging fertility. Other less well-known types of treatment can also carry this hazard. Is it possible to protect yourself from this unwanted side effect? In many cases, it is. Let’s look at some of the options.

 

Which cancer treatments can affect fertility?

Many types of cancer treatment can have an effect, either temporarily or permanently, on a woman’s fertility. This is because the ovaries contain a finite number of follicles which gradually reduce over a woman’s life. The most common cancer treatments accelerate the reduction of these follicle numbers and can also prevent them from maturing. As a result,  the ovaries are unable to regenerate. This can lead to premature ovarian failure (also known as early menopause).

Chemotherapy affects the ovaries, causing a cessation of egg production as well as oestrogen production. It can also reduce the quality of the remaining eggs. In some cases, menstrual periods and fertility restore naturally after treatment. For others, the impact is permanent. There is no way to guarantee the outcome.

 

How can you protect your fertility before cancer treatment?

A cancer diagnosis is a major life event. You may not feel up to thinking about other things, especially fertility. The support of a close friend or family member can be a great help. You should also consider counselling or psychological support, which can help to guide you while considering fertility preservation options.

  • Embryo freezing, or embryo cryopreservation, is a well-established technique to preserve fertility. It follows the IVF pattern of ovarian stimulation, egg retrieval and fertilisation in the laboratory. They then develop into embryos. The embryos are frozen, and stored. They can be thawed and transferred to the patient’s uterus when the time is right.
  • Egg freezing, also known as vitrification, is a similar process where eggs are collected but then immediately vitrified. They are then stored for future use. When they are thawed and fertilised, the resulting embryos can be used in a fertility treatment.
  • Ovarian shielding is a procedure in which the ovaries are shielded by a protective cover. The protective cover is placed externally over the vulnerable areas, such as the reproductive system. This protects them from scatter radiation during radiotherapy.
  • In vitro maturation of oocytes is a technique which can be particularly important for patients whose cancer treatment is urgent. It can be used by those with not enough time for ovarian stimulation, or where the hormonal medication used in ovarian stimulation is contraindicated because of the type of cancer they have. Immature oocytes are retrieved from small follicles without, or with only minimal, stimulation. They are matured in a suitable culture in the laboratory, to be stored for future use in an IVF cycle. It is important to remember that in vitro maturation of oocytes and the use of GnRH agonists are still considered investigational by several authorities.

There are many fertility preservation options to you before cancer treatment. The right one depends on your individual case, the nature of your cancer diagnosis, plus a number of other factors such as age and fertility status. A medical practitioner with an understanding of cancer treatment and fertility preservation can recommend the right choice for your case.

 

Contacting IVI              

At IVI, we have worked for many years to offer cancer patients a way to preserve their fertility. This means that they can focus on their treatment with peace of mind, with the option of having a baby in the future. With every fertility treatment, we offer counselling services to support you through the process and soothe any worries you have.

If you, your partner or a loved one have been affected by these issues, we are here to help. If you would like to speak to us, just complete our online contact form and we will be in touch.

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