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Cancer And Infertility

Cancer And Infertility

If you want to become a parent after you have been diagnosed with cancer, we would like to give you the information you need to make that happen.
We encourage you to use this information:

  • To understand how your fertility can be affected by cancer and cancer treatments.
  • To help you think about planning your family before, during and after cancer.
  • To educate your friends, family and caregivers about why planning your family is important to you.

  • Men
  • Women
  • Important Tips
  • Special Consideration
  • Contact Us
    • Infertility means that you cannot initiate a pregnancy. For men, infertility happens when:

      • You do not produce sperms.
      • You produce very low quantities of sperm or very low-quality sperms.
      • Damage to the reproductive system or sperm transport system prevents sperm from exiting the body.

    • Fertility Risks

      The risk of infertility from cancer treatments depends on many things including:

    • CHEMOTHERAPY
      • Type
      • Duration
      • Dose
    • SURGERY
      • Location
      • Scope of surgery
    • RADIATION
      • Location
      • Dose
    • OTHER
      • Age
      • Pre-treatment fertility status
      • Cancer type

    • Fertility Preservation Options

      There are several ways to preserve fertility before cancer treatments. The following are options you may consider in order to minimize damage to your reproductive system and/or preserve your sperm.

    • SPERM BANKING

      A semen specimen is produced, analyzed, frozen and stored for future use.

    • TESTICULAR SPERM EXTRACTION (TESE)

      A surgical procedure for men post puberty in which testicular tissue is obtained and examined for sperm cells to be used immediately for IVF or frozen for future use.

    • RADIATION SHIELDING

      Special shields are placed over one or both of the testicles during radiation treatment.

    • TESTICULAR TISSUE FREEZING

      Testicular tissue, including the cells that produce sperm, is surgically removed, analyzed, frozen and stored. This procedure is mostly aimed at prepubescent boys who are not yet producing sperm.
      *experimental

    • Possible Fertility Outcomes

      Cancer treatments can affect the reproductive system in many ways. After treatment, your fertility may fall into one of these categories:

    • NORMAL FERTILITY

      Normal sperm function and count. Many men undergo cancer treatment and are able to father children naturally with no change in their fertility.

    • TEMPORARY INFERTILITY

      No sperm during ejaculation. Sperm production may stop for a temporary amount of time. It may return immediately or many years after the cancer treatment ends.

    • COMPROMISED FERTILITY

      Compromised sperm function and/or count. This can occur due to impaired sperm production, interference with hormone production or damage to the nerves and ducts that carry sperm out of the body. This can make natural conception hard and may require the assistance of fertility doctors.

    • PERMANENT STERILITY

      No ejaculated sperm. Some men will no longer produce sperms after treatment. There may be low levels of sperm in the testicles that may be used to try to have children with help from a doctor.

    • Parenthood Options after Cancer

      There are many ways to become a father after cancer. After your cancer treatments end a test called a semen analysis can measure your fertility. Based on the results of the test, the following may be the options for you:

    • NORMAL FERTILITY
      • Natural conception
      • Adoption
    • TEMPORARY INFERTILITY
      • Natural conception
      • Conception with the help of a doctor using fresh or banked sperm, donor sperm or TESE
      • Adoption
    • COMPROMISED FERTILITY
      • Natural conception
      • Conception with the help of a doctor using fresh or banked sperm, donor sperm or TESE
      • Adoption
    • PERMANENT STERILITY
      • Conception with the help of a doctor using fresh or banked sperm, donor sperm or TESE
      • Adoption
    • Important Tips

      • Not all cancers and cancer treatments will affect your ability to have a baby. Ask your oncology team about your risks and consult a male reproductive specialist if possible.
      • Sperm banking is the most successful and least expensive way to preserve your fertility. It should be done before the cancer treatment start.
      • Even if you have a very low sperm count, sperm banking is generally recommended.
      • Sperm can be frozen for many years and still be used to try to have a baby.
      • Due to possible genetic damage to sperm from cancer treatments, doctors usually recommend waiting six to 12 months after the end of chemotherapy or radiation before trying to conceive naturally.
      • Sperm production may return immediately or many years after cancer treatments. If you do not want to become a parent, you should use contraception, even if you think you are infertile.
      • Children born to cancer survivors are not at higher risk for birth defects of cancer, unless the cancer involved is caused by a known genetic mutation. If this is the case, it may be possible to use certain genetic screening methods to help prevent passing the gene mutation on to your children.
    • Infertility is when you cannot start or maintain a pregnancy. For women, infertility happens when:

      • The ovaries no longer contain a supply of health eggs.
      • Damage to the reproductive system prevents a fertilized egg from successfully implanting and growing in the uterus.
      • Damage to the reproductive system prevents you from being able to carry a pregnancy.
    • Fertility Risks

      The risk of infertility from cancer treatments depends on many things including:

    • CHEMOTHERAPY
      • Type
      • Duration
      • Dose
    • SURGERY
      • Location
      • Scope of surgery
    • RADIATION
      • Location
      • Dose
    • OTHER
      • Age
      • Pre-treatment fertility status
      • Cancer type
    • Fertility Preservation Options

      There are several ways to preserve fertility before cancer treatments. The following are options you may consider in order to minimize damage to your reproductive system and/or preserve your eggs.

    • EMBRYO FREEZING

      Mature eggs are removed through a surgical procedure and fertilized in the lab with sperm to create embryos. Embryos that develop successfully are frozen for future use.

    • EGG (OOCYTE) FREEZING

      Mature eggs are removed through a surgical procedure and frozen for future use.

    • OVARIAN SHIELDING

      Special shields are placed over the site of the ovaries during radiation treatment.

    • OVARIAN TRANSPOSITION

      Ovaries are surgically moved higher in the abdomen and away from the radiation field to minimize exposure and damage.

    • FERTILITY-SPARING SURGERY

      Mature eggs are removed through a surgical procedure and fertilized in the lab with sperm to create embryos. Embryos that develop successfully are frozen for future use.

    • OVARIAN TISSUE FREEZING*

      Part or all of an ovary is removed through a surgical procedure. Removed tissue that contains hormone-producing cells are divided into strips and frozen for future use.

    • OVARIAN SUPPRESSION*

      Gonadotropin-releasing hormone analog treatments are used to cause the ovaries to temporarily shut down.
      *experimental

    • Possible fertility outcomes

      Cancer treatments can affect the reproductive system in many ways. After treatment, your fertility may fail into one of these categories:

    • NORMAL FERTILITY

      Many women who undergo cancer treatment have no change in their fertility and are able to have a baby naturally.

    • FERTILITY FOLLOWED BY EARLY MENOPAUSE

      Many cancer treatments damage some, but not all, of the eggs in your ovaries. This means that you may have a period of time when you are fertile after cancer treatments and then go into early menopause.

    • COMPROMOSED FERTILITY

      This can happen from damage to the ovaries, hormone production or reproductive system. This damage can make natural conception hard, but pregnancy may be possible with help from a fertility doctor.

    • IMMEDIATE MENOPAUSE

      This can happen if your eggs are damaged or destroyed by your cancer treatments and/or your reproductive organs are damaged or removed.

    • Parenthood Options after Cancer

      There are many ways to become a mother after cancer. After your cancer treatments end, a doctor can measure your fertility with hormone testes and ovarian ultrasounds. Based on the results of these tests and your ability to carry a pregnancy, the following may be the options for you:

    • NORMAL FERTILITY
      • Natural conception
      • Other family-building options such as adoption and surrogacy
    • FERTILITY FOLLOWED BY EARLY MENOPAUSE
      • Natural conception
      • Fertility preservation options in case you enter menopause before you complete building your family
      • Conception with the help of a doctor using frozen embryos, eggs or ovarian tissue
      • Donor eggs or embryos
  • Important Tips

    • Not all cancers and cancer treatments will affect your ability to have a baby. Ask your oncology team about your risks and consult a reproductive specialist if possible.
    • Even if your period returns, damage to your ovaries from your cancer treatments may put you into menopause five, 10 or even 20 years earlier than is common.
    • Eggs, embryos and ovarian tissue can be frozen for many years and still be used to try to have a baby.
    • Your medical team may recommend that you wait anywhere from 6 months to 5 years after cancer treatments to try to get pregnant.
    • The return of your period does not always mean that you are fertile – and the absence of a period does not always mean that you are infertile. If you are not ready to become a parent, you should use contraception, even if you think you are infertile.
    • Current research shows that pregnancy after cancer does not cause recurrence, even after breast cancer.
    • Some cancer treatments can cause long-term damage to your heart and lungs. This damage can sometimes complicate pregnancy. Ask your doctor if pregnancy is safe for you.
    • Children born to cancer survivors are not at higher risks for birth defects or cancer, unless the cancer involved is caused by a known genetic mutation. If this is the case, it may be possible to use certain genetic screen methods to help prevent passing the gene mutation on to your children.

  • BREAST CANCER

    SPECIAL CONSIDERATIONSAVAILABLE OPTIONS
    Some breast cancers are hormonally sensitive. This means that standard fertility treatments and medications may be unsafe. There are new fertility options and medication choices that may be safer for breast cancer patients.
    Some breast cancer patients carry the BRCA gene and do want to pass it on to their children. It may be possible to use certain genetic screening methods to help prevent passing the gene mutation on to your children.
    Some breast cancer patients carry the BRCA gene and are at higher risk of ovarian cancer and may want their ovaries removed. It may be possible to build your family or preserve your fertility before having your ovaries removed.
  • GYNECOLOGIC CANCERS

    SPECIAL CONSIDERATIONSAVAILABLE OPTIONS
    Some gynecologic cancers are hormonally sensitive. This means that standard fertility treatment and medications may be unsafe There are new fertility options and medication choices that may be safer for gynecologic cancer patients.
    Some gynecologic cancer surgeries can affect future fertility or the ability to carry a pregnancy. For patients with early stage cancers, fertility-sparing surgery may provide successful preservation of your fertility / ability to carry a pregnancy.
    Radiation to the pelvic area can cause changes to the uterus that may make it more difficult to get pregnant or carry a pregnancy to term Gestational surrogacy many be an option for patients who cannot carry a pregnancy
  • PEDIATRICS

    SPECIAL CONSIDERATIONSAVAILABLE OPTIONS
    Prepubescent boys and girls cannot bank sperm or freeze their eggs or embryos. Experimental options like testicular tissue and ovarian tissue freezing may be available.
    Children may be at risk for early or delayed puberty from their cancer treatments. Both early and delayed puberty can be treatment with medications.
    Girls may go into premature ovarian failure (early menopause) from their cancer treatments Hormone replacement therapy or the birth control pill is often used to treat the side effects of early menopause in young girls, but this does not reverse infertility.

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