Suffering from cancer without having fulfilled the desire to have a child brings an emotional difficulty in addition to facing a threat to one’s life. In principle, a cancer diagnosis generates a great fear of death.
However, today the possibility of early detection and a large modality of treatments available, have drastically increased the possibility of surviving this disease. Once the fear of losing one’s life has passed, new anguish arrives that acquires great importance and must be faced. Among these, one of the most significant is the desire to start a family.
Both cancer and the treatments required for its management can affect the fertile potential in men and women. Ovarian and testicular cancer can affect the function of these organs, which produce eggs and sperm respectively, necessary for the genesis of a pregnancy. The uterus can also be directly affected by cancer and/or its treatment. Often these require surgery with the removal of these organs, thus affecting fertility. In addition, treatment with chemotherapy and radiotherapy in the pelvic area can destroy the egg reserve in the ovaries, drastically reduce the uterus’s ability to carry a pregnancy to term and permanently affect the capacity to produce sperm at the testicular level. This phenomenon tends to be definitive with the use of radiotherapy and sometimes temporary when the treatment is with chemotherapy. Finally, in some cases, hormonal treatment is required, which can also affect the ability to fertilize men and women.
Fortunately, science has also evolved in this aspect. In the search for alternatives for these men and women, victims of cancer, strategies have been developed that can preserve their reproductive potential, despite having to undergo aggressive treatments that would ruin their possibility of becoming parents. Today women can access egg freezing or cryopreservation before their ovaries are removed or the use of chemotherapy or pelvic radiation therapy. These eggs can be thawed and used to form embryos in the laboratory, which are then transferred to the uterus of this woman, already treated and cured of her cancer diagnosis. In this way she will be able to achieve a pregnancy with her own eggs, despite no longer having functional ovaries in her body.
In case there is not enough time to stimulate the ovaries, extract the eggs and cryopreserve them or that the surgery requires to be performed urgently or quickly, today a woman has the possibility of cryopreservation of her ovarian tissue. This can be thawed and transplanted back into your pelvis, thus allowing the recovery, at least temporarily, of its ovulatory function and fertile potential. In this way, you can even have a spontaneous pregnancy.
There are also some therapeutic alternatives in women, with the use of some medicines, which bring the ovaries to a state of rest throughout the cancer treatment. This seems to be a useful strategy in the spontaneous preservation and restoration of female reproductive function after chemotherapy treatment has ended.
In women who have to have surgery removed from the uterus but have their ovaries preserved, a therapy known as surrogacy has been developed. This consists of the extraction of eggs from the woman’s ovaries, to take them to the in vitro fertilization laboratory, where they are united with the sperm of her partner, allowing the formation of embryos that are then transferred to the uterus of another woman to carry the pregnancy for 9 months.
Finally, if it is not possible in any way to preserve the eggs or ovarian tissue, a pregnancy can be sought through in vitro fertilization with donated eggs. These eggs are obtained from young, extremely healthy women with physical characteristics similar to the one who is going to receive the donation. They are taken to the in vitro fertilization laboratory to be fertilized with the couple’s sperm and then transferred to the mother’s uterus, previously prepared.
In the case of men, fertility preservation has an extremely easy, effective and saving strategy. This is the cryopreservation or freezing of semen in liquid nitrogen at minus 196 degrees Celsius.
As you can see, there are multiple strategies to give a light of hope to people who today face the drama of cancer and who still aspire to fulfill their dream of becoming parents.
Dr. Juan Luis Giraldo
