Cancer, Fertility and PGD (Oncofertility)

A cancer diagnosis can raise immediate questions about fertility and pregnancy after treatment. Chemotherapy, targeted immune therapies, bone marrow transplantation, stem cell transplantation, radiation, surgery or other cancer treatments can harm the ovaries and affect fertility. But there is hope for women who want the option to become pregnant after treatment.

It is crucial that you consider fertility preservation options before you start your cancer treatment to determine if they are right for you. Start a conversation with your cancer care team and please consult with us to discuss all possible solutions. Results may vary due to age, diagnosis, type of cancer, location of the cancer, and whether the cancer has spread to the ovaries.

Adult Survivors of Cancer

Thanks to modern medicine, adult survivors of cancer can look forward to full lives. However, the treatments that saved them may have also caused a loss of fertility. Dr. Rizk and Dr. Malik help patients better understand their reproductive health and the risk of infertility.

For women, some therapies cause ovarian damage, ovarian failure, genetic damage to developing eggs, and early menopause, among other reproductive issues. However, embryo banking (IVF), egg banking (unfertilized), ovarian tissue banking and ovarian transposition may be ideal options.

For men, cancer treatments can cause damage to the testes and interference with sperm production. Sperm banking, gonadal shielding, testicular sperm extraction (TESE), and testicular tissue cryopreservation are methods to facilitate pregnancy.

Fertility Preservation

Today, cancer patients have new opportunities to conceive and give birth after chemotherapy, radiation, or surgery. Ideally, the process should begin before cancer treatments when eggs and sperm are unaffected. Premier Fertility Center specializes in fertility preservation and elective egg freezing to help with future fertility. Dr. Rysk and Dr. Torres have special training in fertility and reproductive health and can treat reproductive disorders that affect patients of all ages. They consult with compassion and honesty with newly diagnosed cancer patients regarding fertility preservation. The following

  • Fertility evaluation and diagnosis
  • Fertility preservation prior to cancer treatment
    • Embryo cryopreservation
    • Oocyte cryopreservation
    • Ovarian tissue cryopreservation
    • Sperm cryopreservation
    • GnRH analog treatment
  • Conceiving children after cancer treatment
  • Preimplantation Genetic Diagnosis (PGD) to identify hereditary cancer syndromes and other genetic conditions that affect fertility.

Whole Ovary Freezing

Whole ovary freezing may be an option for cancer patients. It does not require stimulation drugs and can be done immediately without delaying chemotherapy or other cancer treatments. The ovary is removed*, frozen, and transplanted back once you are cancer free. *Note that the periphery of the ovary holds all of your eggs and is preserved before freezing, while the rest of the ovary is surgically removed.

Whole ovary freezing is also an alternative to tubal reversal and is an option for girls with cancer, as well.

Egg Freezing

Egg freezing (cryopreservation) is a method in which eggs are collected and frozen through a slow-freeze method or a flash-freezing process (vitrification). The eggs are stored for implantation after cancer treatment.

Depending on the patient’s cycle and response to fertility drugs, it may take from six weeks to nine months to successfully retrieve eggs for freezing. You must collaborate with your oncologist and fertility specialist regarding any delay in cancer treatments. An estrogen-dependent cancer may grow due to the circulation of estrogen during fertility treatments, and therefore it is imperative that any treatment is medically monitored.

Embryo Freezing

The freezing of fertilized eggs—or embryos—is often referred to as “embryo banking.” Similar to egg freezing procedures, your egg production may need to be boosted with fertility drugs. Your eggs are harvested, fertilized with partner or donor sperm in a laboratory (also know as in vitro fertilization), then frozen and stored for future use.

Note that your partner’s permission is required before embryos can be implanted, which may be problematic in terms of separation or divorce. For this reason, some women choose to freeze their unfertilized eggs.

Third Party Reproduction

Other options are available to turn patients into parents. Those who are unable to conceive or carry a biological baby can look to other methods.

  • Donor eggs, sperm, and embryos from an anonymous donor
  • Surrogacy, where another woman carries your child

Preimplantation Genetic Diagnosis (PGD)

Patients with hereditary cancer predisposition syndromes or a history of cancer in the family may be concerned about a future risk of cancer and the risk to their children. “Genetic testing” is an option available to “previvors” — those who have not been diagnosed but have significantly increased risk due to hereditary cancer syndrome. They may choose to lower their risk of cancer with procedures such as prophylactic bilateral salpingo oophorectomy.

If you are planning a pregnancy, you may be interested in reproductive options such as preimplantation genetic diagnosis (PGD). Prior to implantation, the PGD procedure helps identify genetic defects in embryos who have been created through in vitro fertilization.