Acting Fast: Fertility Preservation Within 48 Hours of Diagnosis

Fertility preservation remains a critical, often time-sensitive consideration for patients newly diagnosed with cancer, according to Dr. Tony Anderson, CEO and Founder of IVF Academy USA.

In an interview with CURE, he emphasized the importance of rapid decision-making, describing a “48-hour window” in which patients should begin considering their reproductive options before initiating treatment. His insights highlight both the urgency and complexity of these decisions, particularly for women, and underscore the need for earlier and more consistent conversations across the care continuum.

CURE: Your work highlights what you call “a 48-hour window to preserve fertility after a cancer diagnosis”. Can you explain what this window means and why acting quickly can make such a difference for patients who hope to have children in the future?

Anderson: Regarding the 48-hour window, really, time is of the essence. Whenever someone is diagnosed, of course, they want to get into treatment as fast as they can. For men, it's a little bit easier because men can produce a sperm cell today and can go have their sperm frozen today.

Those 48 hours is pretty easy to work with. With women, it's a little more challenging because even if you had your period today, it would still take another 12 to 14 days to get your eggs out because you must go through stimulation. So, the 48-hour window is really along the lines of making a decision, moving forward, and deciding what you're going to do.

Many patients are overwhelmed when they first receive a cancer diagnosis. With that being said, at what point in that process should fertility be discussed, and who should be responsible for bringing it up: the oncologist, fertility specialist, or someone else on the care team?

Everybody needs to be thinking about fertility preservation. I'll give you a good example. My daughter is 24. Of course, she grew up around this her whole life, and she's started stimulation to freeze her eggs. So, it's not so much about waiting until you're diagnosed to think about preserving fertility; the earlier the better. Like I said, she's 24, and I always said that if she got to 30 and hadn't found the perfect partner, I would ask her to freeze her oocytes. I've had my own family and friends that I've suggested freeze their oocytes, so it's about bringing awareness to the community — not just for women, but for men.

But like I said, women are a little more challenged regarding the time it takes for freezing oocytes, and a lot of cancers can be exaggerated through estrogen stimulation. However, there are stimulations that a patient can go through to minimize those estrogen effects. So, I think just being aware of the possibility of freezing oocytes is key, and that starts with the OB-GYN. An OB-GYN sees patients every year and should be asking, "What are your plans for a family?" Having those conversations is vital.

I talked to my own family practitioner; I told her that we are freezing oocytes at our clinic for half the price of what anybody else in the industry is offering. And she said, "I don't have time to talk to the patients about that." I think that's really where healthcare is today. We have the Baby Boomers, who are the largest generation and have influenced the economy for decades, but now Gen Y and Gen Z are just as big.

There's so much demand on the healthcare system today that doctors sometimes can't provide all the care that is needed. I think it should just be part of a general conversation every year with your patients. That's why I'm hoping this conversation will bring awareness to those providers to ask, "Where are you at with your family plans?" and suggest considering preserving oocytes.

Every fertility center out there does it. It wasn't until really about 12 years ago that women could freeze their oocytes with high success; it was very unsuccessful until around 2012, but today, freezing oocytes is just as successful as using fresh oocytes.

At one time in my career I was working at a fertility center in North Carolina where a young man had his sperm frozen in 1983. You think about 1983, and fertility was really in its infancy; the first IVF baby was born in 1978. He had a form of cancer, and his oncologist or someone said, "You should freeze your sperm." He was a teenage boy. 25 years later, we thawed that sperm and helped them have a baby. It was such a really cool experience to be able to do that. I think we'll hear more and more of these stories going forward about egg freezing as well.

Moving forward, for patients who are hearing about fertility preservation for the first time today, what are the most common options available for women and for men before starting cancer treatment?

The most common options? Really, it's very dependent on how young a patient is. We like to say, "how young" instead of "how old." The less young a patient is, the fewer oocytes there are available. That's why, really, time is of the essence. I would say if you're less than 35, start as quickly as you can. If you're greater than 35, you really need to see what your ovarian reserve is.

They can do a test today called AMH (anti-Müllerian hormone), and that'll give you a very good spot check of what your ovarian reserve is. It's very much like doing an A1c for your glucose; basically, it measures how many follicles you probably still have in your ovaries. A good AMH would be greater than 1.5 or 2; the normal range starts around 0.5 and goes up, but the higher your AMH, the more eggs you have. It's probably a good idea to get that test right away and then plan to see a fertility specialist.

I would suggest that every oncologist or OB-GYN have one or two fertility specialists that they recommend. Particularly in the big cities, every big city has IVF labs. Where we have the biggest struggle is really around the middle of the country. Still half the country lives there, but in much more rural areas.

You have the large cities around the perimeter of the United States, but around the center, they call them "fertility deserts" or "oncology deserts." Those people may have to drive to a fertility center in a city, and it's not always convenient to do that. So, the sooner you act, the better it's going to be.

Transcript has been edited for clarity and conciseness.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.