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Preservation of fertility in Cancer Patients

Recent studies have proved that there are 700,000 reproductive aged men and women who have cancer, having many of them concerns about their fertility. Life saving cancer therapies may reduce fertility by damaging the sperm and eggs in male and female respectively. The first aim is to control cancer from spreading, even if the therapy causes sterility. However, there are some other options which may help the patients to preserve fertility of patient, before and after addressing cancer.

Preserving fertility before cancer therapy

Men: Semen samples may be frozen at a sperm bank/fertility center before starting chemotherapy or radiation therapy. Samples can be stored for years and used later for insemination. Absent sperm or low amount results from the underlying cancer. In such case, the sperm can be used for in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

Women: Women problems may be addressed with In Vitro Fertilization (IVF) depending upon the time and circumstances. The Embryo created by IVF is then frozen and may be store for years. Limiting factors for this approach include time, expense, availability of sperm and possible delay of cancer therapy. If radiations exposed to pelvis, the ovaries may be repositioned surgically out of radiation field. This might reduce the risk of damage of eggs.

Areas of research;

1) Freeze ovarian tissue. This experimental technique requires surgery to remove ovarian tissue .Preliminary studies have shown that re-implanted ovarian tissue may survive and function for a limited time.

2) Freeze eggs. This technique is expensive, invasive and may delay the therapy of cancer. Theoretically, frozen eggs may be stored, fertilized and used for embryo transfer. Few babies have been born by this technique as the actual success to this method is quite limited.

3) Ovarian Suppression before cancer therapy. Regarding this theory, suppressing ovarian function may protect the eggs against the adverse effects of cancer therapy. There is a little evidence to support suppression of ovaries before cancer therapy with birth control pills, GnRH agonists, or other means of hormonal suppression.

Fertility after cancer therapy

1) Men. To recover sperm production after cancer therapy, it may take several years. Insemination, IVF can be the effective measurements for achieving pregnancy. If sperm cannot be obtained, pregnancy may be possible by usage of frozen donor sperm. The physician may want to wait for a long time before attempting conception. Most couples may choose adoption.

2) Women, Women are required to consult a fertility specialist for checkup of damaged reproductive organs. However most women are able to conceive naturally or with fertility therapies. If significant damage has occurred, couples may wish to consider egg or embryo donation, a gestational carrier, or adoption to create a family.

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