Oncofertility

Know fertility options before, during, and after certain treatments and/or medications due to cancer and other illnesses.

Oncofertility

Oncofertility links oncology and reproductive research. It’s a part of looking at options for the reproductive possibility of individuals facing certain medications and/or treatment like pelvic radiation, which can be detrimental to reproductive health. The likelihood of damage or permanent sterilization depends on the type of medication, dosage, and age of the patient.

Fertility preservation is not limited to oncology patients. There are a number of patients requiring bone marrow transplants, stem cell transplants, and some rheumatic diseases that can benefit from knowing fertility options during their treatments.

Many questions arise during this time:

  • Will my treatment have any short- or long-term effect on my ability to have children?
  • Can anything be done to prevent infertility before I start treatment?
  • Will any of these options to preserve my fertility interfere with my treatment?
  • Should my doctor refer me to a fertility specialist before treatment?
  • How long should I wait to try to start a pregnancy after treatment?

While it is not certain that there will be damage to the testis (male) or ovaries (female), it is important to be aware of fertility options before, during, and after treatment. Understanding how male and female fertility is evaluated is a crucial part of oncofertility.

Evaluating Fertility

Male Fertility

Male fertility is evaluated by performing a semen analysis. In most cases, the freezing of sperm samples can be done before treatment starts. The frozen samples can be used in the case there is damage to testicular function as a result of treatment like chemotherapy, for example.

Sperm Banking

Sperm banking (sperm freezing) is done before medical treatment begins. Semen samples are typically produced through masturbation in a private collection room. For males who have no sperm in their ejaculate—due either to an obstruction or testicular dysfunction—there is the option of undergoing surgical sperm retrieval. Once collected, the sperm is assessed, processed, cryopreserved (frozen), and stored at our laboratory for future use by IUI or IVF.

Female Fertility

Evaluating female fertility uses a blood test to assess the quality of the remaining eggs. Oocytes, immature eggs, must be harvested and inseminated with sperm in a laboratory (IVF). The resulting embryos, a product of the two week insemination process, can be frozen and stored until the patient is in complete remission and healthy enough to become pregnant.

Oocyte cryopreservation is one of the newest innovations in the field of assisted reproduction. With a procedure called vitrification, ice crystal formation is minimized during freezing. Compared to previous methods of freezing, this has resulted in less damage to oocytes which, unlike embryos, are more prone to injury during the freezing and thawing process. This new technology potentially allows women to cryopreserve oocytes without a significant other and alleviates issues of identifying a sperm source.

Embryo Banking

Embryo banking (embryo freezing) involves harvesting a woman’s eggs and inseminating the eggs with sperm in the laboratory to produce an embryo for future use through IVF. This process takes about two weeks to complete. The resulting embryos are cryopreserved (frozen) and stored until the patient is in complete remission and healthy enough to become pregnant. Collaboration with an oncology physician is critical.

Oocyte (Egg) Banking

Oocyte (Egg) banking is one of the newest innovations in the field of assisted reproduction and has resulted in the birth of more than 1,000 babies worldwide to date. Similar to embryo banking, egg banking also takes about two weeks to complete. The resulting eggs are cryopreserved through a process called vitrification and stored until you are healthy enough to become pregnant. This new technology potentially allows women to bank eggs without a significant other and alleviates issues of immediately identifying a sperm source. Again, collaboration with the treating physician is critical.

What We Offer

As Reproductive Specialists, we can offer counseling and psychological support to discuss:

  • Effects of the diagnosis on fertility
  • Potential effects of treatment
  • Fertility sparing options including:
    • Possible use of medications to prevent damage
    • Surgical Transposition (i.e. moving the ovaries out of the field of radiation)
    • Banking of sperm, oocytes, and embryo(s)
    • Ovarian tissue banking
  • Use of contraception during and immediately following treatment
  • The effects of cancer therapy on sexual desire and erectile function
  • The impact of stress
  • Monitoring a pregnancy with ultrasound and amniocentesis because of the increased risk of miscarriage and birth defects.