Cancer Treatment & Reproductive Health
Fertility is an important issue to consider when cancer treatment is involved. Patients who are at a childbearing age (and hope to one day have children) should talk to their care team about the negative impact cancer treatments can have on their present and future fertility.
Dr. Emily S. Jungheim, a reproductive endocrinologist at Washington University in St. Louis, said that cancer patients should learn about their cancer treatment and its potential influence on reproductive and sexual function. Women should also learn about potential premature menopause. Patients who are candidates for fertility preservation options should know about risks, costs and potential success of treatments. Younger cancer patients want to know how their treatment will impact their future fertility and over 76% of them want to have children. Cancer treatment and its impact depend on the drugs and dosage, the age of the patient and other variables. Dr. Jungheim noted that patients should also talk to a reproductive specialist. She also added that doctors need to consider chemotherapy, radiation and surgical therapies when examining possible effects of treatment on reproductive health.
When consulting a specialist, your diagnosis and the treatment options will be discussed. Patients who want to know more about their future fertility and their reproductive health should ask questions pertaining to their primary concerns regarding:
- whether the treatment will have influence on one's ability to have children
- ways to preserve fertility before actual treatment
- available options if the treatment has an impact on fertility
- post-treatment ability to carry a pregnancy to full term
Which fertility issues can treatments cause?
When it comes to the reproductive health of cancer patients, not all of them will have fertility problems when the treatment is completed. In men, surgery or radiation to certain parts of the brain may result in reduced sperm production. Surgery on the reproductive system may cause erectile dysfunction, and chemotherapy medications can disable you from producing healthy sperm. In women, radiation and chemotherapy medication can cause destruction of ovary eggs as well as induce development of premature menopause, decreasing the chance of becoming pregnant due to ovulation ending. Some women might have to have the organs necessary for pregnancy surgically removed. Radiation or surgical treatment to a certain part of the brain can cause hormones to interfere with ovulation and the menstrual cycle.
How can fertility be preserved?
Specialists recommend that male cancer patients freeze semen before they start their treatment. Later, they can use the sperm to fertilize their partner’s eggs when they decide they are ready to have children. Similarly, women can visit a reproductive endocrinologist to collect eggs before treatment. This procedure is known as cryopreservation. Patients need to use drugs that will make their eggs mature. The next step is egg retrieval. Then embryos are created by fertilizing eggs with sperm. This procedure is called in vitro fertilization. In the final step, embryos are frozen and they can remain in storage for years.
It is recommended that cancer patients talk about this topic with their doctor or members of their cancer care team until some new options for preserving fertility despite cancer treatment become more established and applicable.
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