Fertility Treatments
Fertility preservation
Fertility preservation is the process of storing sperm, eggs, embryos, or other reproductive tissues in order to have a child later.
Table Of Contents
Introduction
In the case of cancer, the treatments like chemotherapy, radiation therapy, etc., may damage your ovaries, directly impacting your fertility.
Your ovaries may also be damaged due to your work being abundant with toxic chemicals and materials (like in a chemical-related factory) or you serving in the military, rendering you infertile. But if you decide to preserve your fertility, you’ll be able to delay the childbearing and also continue with your work.
Your infertility may also be due to some benign conditions like endometriosis, non-cancerous tumors or uterine fibroids, which may be causing you to be at risk for premature ovarian insufficiency. That means your ovaries will stop producing oocytes or eggs earlier in your age than usual.
According to health administrations worldwide, fertility preservation has grown popular in recent times for several reasons. Premature ovarian insufficiency and infertility may not be the only causes of concern while considering fertility preservation. However, whether you take this decision by choice or as a last resort, fertility preservation is fast becoming an excellent option for delaying childbirth.
What Is Fertility Preservation?
Fertility preservation is a technique of preserving or protecting your sperm, eggs, embryos or other reproductive tissues so that you can have biological children. Simply put, this technique can help you preserve your ability to have a child in the future.
You may opt for this technique before undergoing a treatment procedure like chemotherapy, radiation therapy, etc., as they may damage your fertility. The most common fertility preservation procedures are:
- Egg freezing.
- Sperm banking.
- IVF with embryo cryopreservation.
If you have been diagnosed with cancer and are about to undergo treatment procedures, you may have a few queries about fertility preservation. We at Siya Health will tell you all about how the cancer treatment procedures may impact your fertility and what you can do to preserve it before the treatment starts.
Who Is It For?
Generally, fertility preservation is opted by people suffering from serious illnesses, disorders or who are about to undergo life-altering procedures such as a gender change. Other than that, here are a few people who may opt for this procedure:
- People who suffer from endometriosis.
- People who are about to receive treatment for cancer.
- People who suffer from a genetic or congenital disability may affect their fertility.
- People who work at a place abundant with toxic chemicals and irritants or serve their country in defense forces.
- People who are not forward to having children until a particular point in time.
- People who suffer from uterine fibroids.
- People who are about to be treated for autoimmune diseases like lupus.
If you fit in one of the categories mentioned above, you may want to consult with your fertility doctor about having fertility preservation.
Fertility Preservation Options
There are several options for fertility preservation for both males and females. Here are a few options for males:
- Gonadal shielding: One of the most common cancer treatments is radiation therapy, which is known to damage fertility, especially if used around the pelvic area. With the latest techniques, the doctors can concentrate the radiation in a small area. For protection from radiation, the testicles can be covered with a lead shield.
- Sperm cryopreservation: It is a more common fertility preservation option. For this technique, the male first provides a semen sample.
Here are a few options a female may adopt for preserving her fertility:
- Embryo freezing: Also known as embryo cryopreservation, this is the most common fertility preservation technique. After collecting the eggs, they are fertilised with sperm to create embryos.
- Oocyte cryopreservation: The process for this technique is the same as embryo cryopreservation. The only difference is that eggs are frozen in this process before being fertilised with the sperm.
- Ovarian transposition: The doctor may sometimes perform minor surgery to reposition the ovaries and fallopian tubes to an area with no radiation like the abdomen.
- Gonadal shielding: The process is the same for males and females, but the ovaries are protected with lead shields for females.
But some of these preservation techniques will only be for the individuals who have reached puberty. Your doctor will recommend a suitable approach after a thorough consultation.
Does Fertility Preservation Help Kids With Cancer?
Many kids throughout the world are adversely affected by cancer. As a parent, it becomes imperative that you think about their future. As soon as they are old enough to understand the concept of fertility, it should be discussed with your children affected with cancer and receiving cancer treatment. The doctor will take your consent before proceeding with fertility preservation.
After puberty, the fertility preservation techniques will be sperm or eggs cryopreservation. For girls with cancer, who haven’t yet reached puberty, the suitable treatment would most probably be ovarian tissue cryopreservation. In this process, the doctor will surgically remove the ovarian tissue to be frozen and then thawed and reimplanted in the future.
For the boys undergoing cancer treatment before puberty, the doctor may perform surgery to remove the testicular tissue, which is then frozen, to be reimplanted in the future.
Ethics Of Fertility Preservation In Cancer Treatments
The patient should be made aware of the adverse effects of cancer treatments on fertility by the doctor during the initial consultation. It is quite a significant issue, which should be discussed.
Here are a few points that should be discussed during the treatment discussion:
- Estimation of the infertility risk should be attempted for the patient counselling.
- The ability of a patient to undergo fertility preservation in the wake of a new cancer diagnosis or shortened life.
- Effects on the recurrence of the disease due to future pregnancy.
- Use of PGD and PGS, if appropriate.
- Risk to fertility due to the proposed cancer treatment and patient referrals to the fertility and endocrinology specialist.
- Comprehensive patient prognosis.
- Risk of delay in the treatment due to cryopreservation.
- Discussion of benefits and drawbacks to the minors.
- Discuss the risks with the parent and ask for their consent if the treatment is for a child. But if the child has understood the procedure and still refuses, don’t perform the treatment.
- Risks to the forthcoming child.
- Fertility preservation techniques.
- The doctor should meet the concerns shown by the parents about the future offsprings to the child with cancer undergoing fertility preservation with the utmost respect.
- Posthumous reproduction.
- Consultation with the ethics committee.
If there is a risk of infertility, and fertility preservation is being performed to prevent it, the points mentioned above must be discussed.
Risk Of Recurring Cancer
There are currently no instances or evidence that may depict harm to the success of cancer treatments due to fertility preservation techniques. But there is a chance of your cancer worsening because of the delay in the treatment due to fertility preservation.
Although there is no apparent risk of your cancer recurrence because of the fertility preservation techniques, reimplanting the frozen tissues may reintroduce the cancerous cells depending on the cancer type.
Ask Your Doctor
Here are a few questions you, as a patient, must ask your doctor:
- Is infertility possible due to cancer treatments?
- What are the options for preserving fertility during, before or after the cancer treatment?
- How to know if I am fertile or infertile after the treatment?
- How long should I wait for child conception after having treatment?
- Are there any long or short-term effects of cancer treatment on the reproductive system?
- Are there any alternative treatments for reducing the said risks?
- Will any of the fertility preservation techniques affect the success of the cancer treatment?
- What are the options of child conception after infertility due to treatment?
Other than the questions mentioned above, as a woman, you may ask if you will enter premature menopause post-treatment and if it will be temporary or permanent.
Conclusion
Cancer is one of the most terrible diseases around the world. There are several treatments available for cancer, including chemotherapy, radiation therapy, etc. Unfortunately, one of the side effects of these treatments tends to be infertility. If you are an individual who wants to have a child in the future, you may opt for fertility preservation. This process can help you preserve the eggs, sperm or embryos for future child conception attempts.
A few of the factors that may go into choosing fertility preservation are:
- The area or part of your body undergoing radiation therapy.
- Dosage of the treatment and its duration.
- Timeline of the treatment.
- Age and marital status of the patient
If you have any other queries regarding fertility preservation, please consult the Fertility experts at Siya Health, or call our Siya Fertility Counsellor today.
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Dr. Dipesh Sorathiya
M.S. (Obs & Gyn)
DIP. in Gynec Endoscopy (CICE)
- Specialities : IVF, IUI, ICSI
- Experience : 16 years
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