Fertility Preservation Timing and Ethical Planning in Cancer Care

Dr. Tony Anderson, CEO and Founder of IVF Academy USA, sat down for an interview with CURE to discuss how patients and clinicians navigate the urgency of cancer treatment alongside fertility preservation.

He noted how treatment timing decisions, oocyte retrieval processes and long-term ethical considerations around stored reproductive material factor into patient-centered care and planning.

CURE: Patients may worry about taking the time for fertility preservation, as it could delay their cancer treatment. How do specialists balance the urgency of cancer care with the need to protect fertility?

Anderson: You know, I always kind of wondered how I would respond if I was diagnosed with cancer when I was younger. I never even considered it before having kids. I had kids a little later in life, I was in my 30s when all three of my children were born. But if I was diagnosed and I was, say, 25 today or 30, the way I got diagnosed is because I had something going wrong. What if I was diagnosed a month later? Would that have changed the outcome of my cancer treatment? Probably not.

If you're considering that you might want to preserve your fertility, it might be worth extending your treatment for a month. Because if you're a woman, it's going to take probably a month to get a round of oocytes frozen. Usually, you go on birth control pills for 10 days, you come off birth control pills, then you go on medications for another 10 days, and then you can have your oocytes frozen. On average, it's going to be around 20 to 25 days. So, you could look at it like, "Maybe I got diagnosed next month," and you can have that planned out versus rushing into something today that you haven't had a plan around.

What are some of the ethical or long-term planning considerations patients should think about when pursuing fertility preservation before cancer treatment?

I think one of the most important things, too, is you've got to have a plan for what to do with those oocytes in the event you're not here. A lot of fertility centers freeze those oocytes, and historically, fertilized eggs — embryos — froze better than oocytes. Today, that's not the case. But if somebody had a partner and they said, "I want to have a baby with my partner," and they freeze those oocytes or those embryos, what's the disposition of those later?

If you're not here to make that decision, and you give them to your parents or to your partner and then they have another partner, you must be aware of what you want done with those oocytes or that sperm. You should think about that as you go into it.

Yeah, absolutely. That is a great point to bring up for awareness, so thank you for that.

Why I say that is because there was a case (I believe there was a lawsuit around it) where a lady had her oocytes frozen and gave them to her partner. Then she passed away. Or it was sperm that was frozen and he passed away. But then the survivor started having a relationship with someone else, and the question was: Would the deceased have wanted that for their genetic material? We must always look at what the intent was at the time. It's just easier for us in the fertility center if we already have all that spelled out, but it's a lot to digest early on.

A lot of times they say that if you tell a person they are infertile — and the average age of a patient in most IVF centers is around 35 or 36, meaning they've been spending most of their years trying not to get pregnant and then they want to and can't — when you tell them their tubes are blocked, or they have endometrial factors or male factors, it is equivalent to telling them they have cancer. I always look at it like any disease; fertility is treatable if you stay in treatment. That's the key. You can't just go take one round of treatment and then "cure" that disease. Preserving fertility is pretty quick and easy, and I would encourage everybody to be aware and to seek that early on in their life.

Transcript has been edited for clarity and conciseness.

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