cancer survivorWomen are surviving cancer in rates higher than ever before and many of them long for babies once cancer is history. As a result, women of childbearing years who have cancer can expect to discuss with their oncologist their plans for children and medical interventions that can make that happen. Advance planning for a family after cancer is allowing a growing number of cancer survivors to bear their own children after cancer is conquered.

In some cases, cancer can be treated with surgery alone. By avoiding chemotherapy and radiation treatments that destroy a woman’s ovaries, the woman’s chance of bearing children is minimally affected by cancer. Other women will need more extensive cancer treatment that may leave them infertile. For this reason, the steps necessary to preserve a woman’s fertility begin before cancer treatment does.

In recent years, adoption, surrogacy, and embryo donation were the most effective means of becoming a mother after cancer but scientific breakthroughs are giving female cancer survivors more options for bearing a child of their own genetic lineage. Some of these breakthroughs include:

  • Embryo freezing: Embryo freezing is done most often and with better results than all other options to date. Before radiation or chemotherapy begins, a woman undergoes an outpatient procedure that collects eggs from her ovaries. These eggs are then fertilized,  frozen, and stored until the woman is again healthy enough for pregnancy. She is then implanted with her own eggs after in vitro fertilization (IVF).
  • Ovarian transposition: In ovarian transposition, the ovaries are surgically moved away from the radiation target zone and repositioned elsewhere in the body. Eggs can be harvested for IVF when the patient is deemed free of cancer and pregnancy is safe. This method of fertility preservation can be performed on pre-pubescent girls.
  • Radical trachelectomy: Patients with cervical cancer may choose this option, which fashions a cervix out of uterine tissue. This procedure works best when cancer is small and localized enough so that toxic cancer therapies spare the uterus and ovaries.
  • Fertility-sparing surgery: When cancer affects just one ovary, the health of the unaffected ovary is of the utmost importance. Only the cancerous ovary will be surgically removed, leaving the remaining ovary and uterus intact.

Experimental fertility preserving measures include:

  • Egg freezing: Younger women may choose to freeze their eggs before cancer treatments begin, especially if they are too young to have a life partner whose sperm can be used to develop an embryo for freezing.
  • Ovarian tissue freezing: Laparoscopy is used to remove all or part of a healthy ovary. This ovary tissue is then frozen until the woman is declared cancer-free. The frozen tissue is transplanted in the woman’s body and, if it produces eggs, the eggs are harvested and IVF treatments are begun.
  • GnRH analog treatment: Gonadotropin-releasing hormones (GnRH) are used to mimic the menstruation-stopping effect of menopause. This treatment continues throughout the time cancer treatments are administered.
  • Oral contraceptive treatment: This form of fertility-sparing treatment works much like GnRH treatments do, slowing the activity of the ovaries in an effort to save healthy eggs.

Some fertility-preserving treatments are covered under medical insurance policies but others are not. Do discuss all concerns and questions with your gynecologist, your fertility specialist if you are already seeing one, and your oncological team as soon after cancer diagnosis as possible.

Source: "Preserving Fertility in Women Before Cancer Treatment." American Cancer Society. 19 Nov 2012. Web. Retrieved 11 Nov 2013.