Women Should Know Their Options, Risks for Future Fertility Before Starting Cancer Treatment

Cancer can negatively affect fertility after treatment, and women should talk with their doctor about their personal risk and preservation options.

Fertility preservation minimally delayed treatment in women with cancer, and most were able to go on to have a successful birth, according to recent study results.

Clare Meernik, lead author on the study, explained that cancer treatments such as chemotherapy and radiation can affect a patient’s fertility by depleting their egg count, damaging the quality of eggs or sending them into immediate menopause. And although patients do have the option to preserve fertility, such as freezing and storing eggs also known as in vitro fertilization, some may still have concerns.

“However, relatively few young women who are diagnosed with cancer freeze their eggs as fertility preservation because there are a number of barriers to this process,” Meernik, who is a postdoctoral associate at Duke University School of Medicine in Durham, North Carolina, said in an interview with CURE®. “Those barriers include concerns about delaying cancer treatment in order to freeze one’s eggs, and uncertainty about whether cancer survivors are able to successfully become pregnant and give birth after completion of their cancer treatment with the use of their previously frozen eggs.”

Results of the study — which were published in the journal Cancer — demonstrated that median time to cancer treatment was nine to 33 days longer among women who used fertility preservation (95 women) compared to those who did not (469 women). Meernik noted that this is a “fairly minimal” delay, and although these data do not determine its safety, past research has deemed a treatment delay of a few weeks is not expected to increase the risk of cancer recurrence or worsen survival.

Additionally, women who initiated assisted reproductive technology before cancer treatment may be more likely to have a live birth compared with woman who initiated after treatment. This could be a result of freezing eggs that are still of high quality because they have not been harmed by the cancer treatment, Meernik explained.

“Fertility preservation is so important for young women diagnosed with cancer who want to have children in the future because not only can cancer treatment deplete the number of eggs that a woman has, that treatment can also damage the quality of the remaining eggs,” she said. Meernik mentioned that fertility preservation before cancer treatment may also benefit a woman regardless of the type of cancer treatment they receive.

“Undergoing fertility preservation before starting cancer treatment means that a woman is able to freeze and store eggs that have never been exposed to potentially harmful cancer treatment. Based on the type of cancer treatment received, the eggs retrieved before cancer treatment may be higher quality than eggs retrieved after cancer treatment, thus increasing the likelihood of successfully becoming pregnant and giving birth with those eggs.”

These results highlight that if a patient does want to have children after treatment, fertility preservation can be completed while only delaying treatment minimally and that a majority of women have a successful birth.

“Ultimately, the decision to undergo fertility preservation is a personal one that needs to be thoroughly discussed between the patient and their doctor,” she said. “We hope that data from this study can be used to help inform these patient-provider discussions and allow more women to undergo fertility preservation if such a delay is deemed acceptable by themselves and their doctor.”

Meernik added that even if a patient with cancer has not thought about the future of their fertility or is not worried about it, they should still be talking to their doctor about how it may be impacted.

“Even if you, as a patient diagnosed with cancer, have not thought about whether you want children in the future or are unsure, be aware that some cancer treatments may make that impossible without the use of fertility preservation” she said. “Talk to your doctor about how your specific cancer treatments may harm your fertility and explore all your options for having future children. And if cost is a concern, the Alliance for Fertility Preservation website provides a list of multiple financial assistance programs that may be able to help.”

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