Know Your Fertility Options
Before, During, and After Cancer Treatment
by Teresa K. Woodruff, PhD, and Kate Waimey Timmerman, PhD
In April 2010, Tiffany and Dave were juggling their busy lives and in the midst of planning a European vacation when Tiffany noticed an unusual lump in her breast. As a typical, healthy 28-year-old, Tiffany assumed the lump was benign, and when she went to the doctor to have it checked, she was shocked to find out it was breast cancer.
Immediately after her diagnosis, Tiffany was sent to a variety of specialists, including the fertility preservation patient navigator at Northwestern Memorial Hospital in Chicago, IL. The navigator discussed the potential effects that cancer treatment could have on her reproductive health. Since the couple planned to have children, the navigator set Tiffany up with a preservation specialist. Dave reveals, “I didn’t know much about chemotherapy, and I didn’t even think about how it would affect her fertility because she’s so young.”
After the couple discussed their options, they decided to undergo embryo banking. “We started that process, and we were able to bank six embryos,” Tiffany says.
Tiffany is one of the increasing numbers of young cancer survivors who are discussing fertility with their doctors prior to, during, and after cancer treatment. Over the past 10 years, the number of options for men, women, and children to preserve their fertility in the midst of potentially damaging chemotherapy, radiation, and surgery, has significantly increased. These options have launched a new area of focus in cancer care – oncofertility, which examines the decision-making, communication, and financial considerations of survivors wishing to have children after cancer.
Adult women can choose among a variety of fertility preservation options, including freezing eggs, embryos, or ovarian tissue prior to treatment. Men may bank sperm or undergo testicular sperm extraction. In addition, experimental procedures that may provide reproductive opportunities for children by the time they are ready to have their own children are available.
Dr. Kate Timmerman
Currently, prepubescent girls who have cancers of the pelvis or the blood may not be able to take advantage of fertility preservation treatment. However, scientists are developing a technique to mature ovarian follicles that contain im- mature eggs, outside of the body. Advances in techniques like this will provide hope to the many young survivors who wish to have children after cancer.
Survivors who find themselves dealing with infertility after cancer treatment also have more family-planning options now than ever before. In addition to advanced biological treatments, surrogacy and adoption are more available to cancer survivors today due to advances in research and increased public awareness.
A National Effort
Young cancer survivors can discuss fertility with their local oncology treatment team, or they can contact the national fertility preservation patient navigators at the Oncofertility Consortium (oncofertility.northwestern.edu), a group of healthcare providers and researchers with experience integrating reproductive options into cancer treatment and survivorship. They also connect survivors to additional services within the cancer community, such as those that provide emotional and financial support.
Cancer survivors can be empowered by learning about the reproductive effects of treatment, as well as their fertility-preservation options. Websites, books, social media tools, and even mobile apps now exist to educate cancer survivors. Survivors can also inform future oncofertility research efforts by participating in studies about their reproductive experiences during and after cancer treatment.
Together, the efforts of survivors, researchers, oncology teams, reproductive specialists, and advocates result in more young people discussing their fertility options before beginning treatment. These efforts are also increasing options for survivors who were unable to preserve their fertility before treatment.
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Dr. Teresa K. Woodruff is the Thomas J. Watkins Professor of Obstetrics and Gynecology and the chief of the Division of Fertility Preservation in the Feinberg School of Medicine at Northwestern University in Chicago, IL. She coined the term oncofertility to describe a new discipline that bridges oncology and reproductive medicine in order to discover and apply new fertility options for young survivors with fertility-threatening diseases or treatments. Dr. Kate Waimey Timmerman is the program director of the Oncofertility Consortium based at Northwestern University’s Feinberg School of Medicine.
Talk to your oncology team about your fertility, and ask to discuss your options with a reproductive specialist. Contact a fertility preservation patient navigator at the national fertility hotline, 866-708-FERT (3378) to be put in touch with a fertility expert in your region. Visit SaveMyFertility.org to read more about your options and to download the iSaveFertility iPhone app.
This article was originally published in Coping® with Cancer magazine, May/June 2012.