Regardless of the type of cancer, receiving a diagnosis can be earth-shattering. However, depending on how early it's caught, different types of treatment can provide optimistic results. While people with cancer usually need to begin their doctor-recommended treatment as soon as possible, it's important to understand how it will affect your fertility both short- and long-term. To help you preserve your fertility and increase the likelihood of growing your family in the future, here's some important information on fertility preservation options before you begin cancer treatment.
Understanding Fertility in Males
Male fertility is intricately linked to the production, quality, and functionality of sperm. Sperm are continuously created in the testes during a man's reproductive years, but sperm health can be affected by hormonal imbalances, varicoceles, infections, genetic factors, and lifestyle choices. Although there's technically no reproductive endpoint for men as sperm production generally continues, the quality and quantity of sperm can decline with age and may affect your fertility.
Understanding Fertility in Females
Female fertility is more complex and requires a balance of estrogen and progesterone regulation, ovulation, and a healthy reproductive environment. Unlike men, women are born with a finite number of eggs. After their first menstrual cycle, a mature egg is released from the ovaries each month, gradually decreasing the reserve over time until menopause is reached. At this time, ovulation stops, and a woman is no longer fertile. Like male fertility, several factors can impact the health of the egg and the environment necessary for implantation.
Why Cancer Treatment Can Affect Fertility?
As a cancer patient, your doctor may ask about your desire to grow your family before treatment starts. This is because certain treatments for cancer can result in fertility problems. Some of the most notable include:
- Surgery — Surgical interventions aimed at removing cancerous tissues can inadvertently affect reproductive organs. For example, removing a testicle or an ovary directly impacts the production of sperm or eggs.
- Radiation Treatment — Radiation therapy can damage or destroy healthy cells, including those responsible for sperm and egg production. Reproductive organs in the pelvic area, such as the testicles or ovaries, are particularly vulnerable. Radiation also affects the hormonal balance necessary for reproductive health.
- Chemotherapy — Chemotherapy can also harm healthy cells, including germ cells responsible for fertility. The toxicity of certain chemotherapy drugs may lead to a decline in the quantity and quality of eggs or sperm. Chemotherapy also impacts hormonal signals.
- Medication — Certain cancer medications can alter hormonal balances or have toxic effects on reproductive cells.
Which Cancers Can Cause Fertility Concerns?
Fertility may be affected by any cancer cells, depending on their aggressiveness and location. However, some of the most common types of cancers that result in problems with fertility and sterility include:
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Testicular Cancer (Males): Testicular cancer directly affects the testicles, where sperm production occurs. Treatment may also impact sperm production and quality, which further decreases fertility over time.
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Ovarian Cancer (Females): Ovarian cancer can lead to the removal of one or both ovaries during treatment, which impacts egg production and hormonal balance. If an ovary is removed, the eggs inside it will no longer be viable, which can significantly impact a woman's fertility window.
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Cervical Cancer (Females): Cervical cancer and its treatments can affect the cervix and uterus, resulting in a problematic environment for implantation and fetal development. Depending on the intensity of the treatment, this can affect a woman's fertility.
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Prostate Cancer (Males): Prostate cancer and certain treatment plans can affect fertility in males. Depending on the location of the cancer and cancer treatment, sperm production may be impacted, which can result in infertility. However, this isn't always the case, so it's important to talk to your doctor and a fertility expert if you're concerned.
Fertility Preservation Before Cancer Treatment in Males
Men have a few different options to preserve their fertility before getting treated for cancer. For the best outcome, try to start talking about fertility problems with your doctor early on in your cancer diagnosis. This allows you to understand your options better, ask the fertility specialist questions, and choose the best preservation method for your circumstances. As a male, you can preserve fertility through the following methods:
Sperm Banking
Sperm banking is a widely utilized and effective method for preserving male fertility before undergoing cancer treatment. This process involves the collection, freezing, and long-term storage of sperm for future use. Samples can be retrieved from either traditional ejaculation, electroejaculation, or retrograde ejaculation collection from the bladder. There are some limitations to this type of fertility preservation, so talk to your doctor to see if it's right for you.
Sperm Extraction
In cases where traditional sperm banking may not be feasible, various sperm extraction techniques provide alternative options. These methods, such as testicular sperm extraction (TESE) or microdissection TESE, enable the retrieval of sperm directly from the testicles. Sperm extraction becomes particularly valuable for individuals who don't have sperm present in their semen (i.e., those who have undergone a vasectomy).
Precautionary Steps During Treatment
Your doctor may also recommend radiation shielding depending on the cancer and the treatment. Radiation can destroy sperm cells, but if one of the testicles is shielded, it may help preserve healthy cells. Men with testicular cancer in only one testicle can shield the other. However, it's not guaranteed that you will remain fertile after cancer treatment, so it may be best to pair this with another option just in case.
Fertility Preservation Methods for Females
Regardless of if you've been diagnosed with breast cancer or early-stage cervical cancer, there are ways to preserve fertility for women as well. These methods can be effective years after cancer treatment, allowing you to grow your family on your terms. Some options for fertility preservation in women include the following:
Cryopreservation
Cryopreservation is a common fertility preservation method for women that involves freezing and storing eggs, embryos, and/or ovarian tissue. This technique offers women the flexibility to preserve their fertility before cancer treatment, allowing them to pursue family-building options even years after the completion of therapy. Egg banking is the most common, but fertilized eggs from vitro fertilization (IVF) can also be frozen.
Advances in cryopreservation technology have significantly improved the chances of successful pregnancies from thawed eggs and embryos, but it's still important to discuss your options with your doctor.
Ovarian Transposition and Radiation Shielding
Ovarian transposition involves surgically moving the ovaries to a position that would shield them from the direct effects of radiation. It's most commonly performed in younger girls to try and help maintain fertility naturally, but it's not always 100% effective.
Precautionary Surgery
Early stages of ovarian cancer and cervical cancer may allow surgeons to remove only the affected area. This could mean removing only one ovary or removing the cervix while leaving the uterus intact. Talk to your doctor to determine whether you're a candidate for this type of precautionary surgery.
Facts About Fertility Preservation After Cancer Treatment
Cancer survivors who have taken methods to preserve their fertility can go on to try a few different options. Some cancer survivors may be able to conceive naturally, depending on the type of proactive treatment. Others may have to try in vitro fertilization (IVF) to achieve a successful conception. For those that still struggle, intrauterine insemination (IUI) may be performed. This involves the placement of sperm directly into the uterus for a higher chance of success.
Options to Consider if You Experience Fertility Issues
If either you or your partner are facing a cancer diagnosis and worried about fertility, it's important to talk to your cancer care specialist and a fertility specialist to understand your options. There are ways to tackle infertility together and grow your family. Some of the most common options include:
- Sperm donors
- Embryo donors
- Egg donors
- Surrogacy
- Adoption
Getting a donor for either sperm, embryo, or eggs will allow couples to carry their child naturally, but if the uterus isn't viable for fetal development, you may have to explore other options. Many couples consider surrogacy, but there can be high costs associated with this. Of course, adoption is also always an option to help you grow your family.
A cancer diagnosis can be difficult to handle, but it doesn't mean you should give up hope. Regardless of whether you receive a urologic cancer diagnosis or are suffering from another urologic condition, Byram Healthcare provides high-quality, supportive urologic products to help you manage your symptoms. Contact us today to learn more.
