When faced with a cancer diagnosis, uncertainty and fear about what will happen and how it will be able to be faced are the most common feelings among those patients who will begin to walk a path of therapy and recovery.
There are many thoughts that go through the mind at this difficult time, however, in the midst of so many questions about treatments and adverse effects, fertility or desire to have a child in the future becomes an important aspect to consider for those who dream of being parents after overcoming cancer.
Why should you think about fertility when facing a cancer diagnosis?
Treatment for cancer diagnoses is linked to chemotherapies or radiotherapies that affect male and female fertility by exposing the reproductive organs to radiation or very high doses of drugs that affect the woman’s eggs/oocytes and sperm in the man.
These types of therapies focus on attacking the rapidly dividing cells that produce cancer tumors, however, the impact of this drug could indirectly affect the reproductive cells that work in favor of fertility.
The effect that this type of treatment could cause on reproduction will also depend on the classification of the tumor, its location, the age of the patient, the doses of drugs formulated, exposure to radiation, and the part of the body receiving radiotherapy. For this reason, it is important to talk to your treating doctor about the risks of infertility and the possibilities that exist to preserve eggs or sperm before starting cancer treatment.
How does cancer treatment affect male fertility?
In male fertility, the most important thing is the quantity and quality (morphology and motility) of the sperm produced by the testicles, since these are responsible for fertilizing the woman’s eggs to achieve the formation of an embryo and thus a pregnancy.
When exposing the man’s reproductive organs to treatments such as radiotherapy or chemotherapy, there could be an affectation in the testicles or alterations in sperm production, which would limit the possibility of conceiving.
The damage caused by cancer treatments will depend on the impact they have on spermatogonia (sperm stem cell), which is responsible for the production of sperm through spermatogenesis.
Testicular cancer, prostate cancer, lymphomas and leukemia are some of the cancers that most affect male fertility, however, if you want to have a child in the future, it is important to consult a fertility specialist before any cancer diagnosis.
How does cancer treatment affect female fertility?
In the case of women, treatments to attack cancer directly affect the ovarian reserve or the organs of the reproductive system such as the endometrium or uterus.
Infertility due to chemotherapy or radiotherapy is mainly due to the high exposure of radiation in the pelvic area of the woman, which could affect the quality of the eggs and the functionality of other organs. Additionally, high doses of drugs could alter female reproductive cells, hindering the release of eggs in the menstrual cycle by depleting or depleting the ovarian reserve.
It should be noted that as a result of radiotherapy and/or chemotherapy, and its effect on oocytes, early menopause can develop that leads to infertility. However, it is also important to know that there are options to protect the ovaries before starting such treatment. It is essential to consult with a specialist to analyze the options that exist in favor of the care of the reproductive system.
What options are there to preserve fertility in the face of a cancer diagnosis and treatment?
Currently, the area of assisted reproduction offers different alternatives to preserve the eggs or sperm of those patients who are about to start cancer treatment.
In this regard, it is essential that the decision to make use of these alternatives is agreed upon by the oncologist and a fertility specialist, since all the pros and cons of these procedures must be analyzed.
In women:
Cryopreservation of eggs and/or embryos: this technique, also known as vitrification, consists of extracting the woman’s healthy eggs and then sending them to an IVF laboratory to be treated and stored at low temperatures, which will allow them to be preserved until the moment the woman decides to start the search for a pregnancy.
Cryopreservation of ovarian tissue: This procedure involves the removal of a portion of the ovarian tissue or the entire ovary through surgery. It will then be stored in the laboratory to preserve its function and thus preserve fertility.
Medical treatment to protect the ovaries: The use of GnRH agonist is recommended to stop the activity of the ovaries and thus protect them during chemotherapy. After the cancer treatment is overcome, the injection is stopped and the functioning of the ovaries is activated.
Surgical procedure to protect the ovaries: this management is recommended for patients who will undergo radiotherapy to the pelvic area, but do not require chemotherapy; It consists of a surgery that aims to move the ovaries, within the body itself, to areas far from the area of radiation. After the treatment is finished, the ovaries are placed back in their natural position.
In men:
Sperm cryopreservation: this technique allows sperm to be frozen for long periods of time in order to preserve their fertility. The sample is taken by means of semen collection by ejaculate or through sperm extraction and aspiration procedures.
Protection of the testicles during radiation: for patients who require radiotherapy in areas near or directly on the testicles, a “shield” is used to protect the area; This is called gonadal armor or gonadal preservation.
If you are currently experiencing a cancer diagnosis and are looking for alternatives to preserve your fertility, contact us. We are here to accompany you and take care of you!
Medellin: (4) 268 8000
Bogota: (1) 746 9869
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Pereira: (6) 340 1709 – 311 7706212
Manizales: (6) 8962220
References
ESHRE European Society of Human Reproduction and Embryology. Information about the preservation of female fertility. 2020 version.
American Cancer Society. How to preserve fertility in men with cancer. 2020. Available in: https://www.cancer.org/es/tratamiento/tratamientos-y-efectos-secundarios/efectos-secundarios-fisicos/efectos-secundarios-sobre-la-fertilidad-y-la-sexualidad/la-fertilidad-en-los-hombres-con-cancer/preservacion-de-la-fertilidad-en-los-hombres.html
American Cancer Society. How cancer and cancer treatment can affect fertility in women. 2020. Available in: https://www.cancer.org/es/tratamiento/tratamientos-y-efectos-secundarios/efectos-secundarios-fisicos/efectos-secundarios-sobre-la-fertilidad-y-la-sexualidad/la-fertilidad-en-las-mujeres-con-cancer/como-el-tratamiento-contra-el-cancer-puede-afectar-la-fertilidad.html
