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Fertility Preservation: Understanding your Alternatives before Cancer Treatment

No comments yet July 9th, 2019
Infertility Specialist Dr. Pankaj Talwar

What is Fertility Preservation?

Fertility preservation is an effort of preserving eggs, embryos, and sperms of individuals who have been diagnosed with cancer or are preparing to undergo treatment, so that they can have children in the future. This method allows these individuals to remain potentially capable of having children once the treatment is complete.

Chemotherapy and radiation therapies for cancer can affect reproductive health and potential of adolescents and young adults.

The protocols that impede ovarian and testicular function are radiotherapy to the pelvic area and lower abdomen and types of chemotherapy and drugs administered.

Chemotherapies with high risk include procarbazine and alkylating drugs such as cyclophosphamide, ifosfamide, busulfan, melphalan and chlorambucil.

Some Drugs with medium risk to the fertility potential are doxorubicin and platinum analogs such as cisplatin and carboplatin.

On the other hand few drugs have low risk of gonadotoxicity post treatment. These are plant derivatives such as vincristine and vinblastine. Antibiotics such as bleomycin and dactinomycin and antimetabolites as methotrexate and 5-fluoruracil also have low toxicity potential.

These drugs specifically attack the dividing cells in the body, including healthy cells having reproductive potential such as spermatozoa and ovarian egg. Depending on the dose and duration of administration, these cures can have varying effects on reproductive health and potential.

Talk to your oncologist and ART clinicians as soon as disease is diagnosed.

Women have option of oocyte freezing, embryo freezing, ovarian cortex freezing or ovarian transposition.

The men can undergo semen freezing or testicular tissue freezing. The other options can be modification of the chemotherapy drugs and dosages and timely treatment.

Always remember that Pre chemo- radiation therapy fertility management is a better option.

Early action is the treatment. Children are young and don’t understand the ethical issues involved in the management of such cases.

If the child is pre pubertal age, options include testicular and ovarian cortex freezing.

In the post-pubertal age group – oocyte or sperm cryopreservation may be done.

Legal consent has to be taken before any intervention.

Efforts to preserve the fertility of a pre pubertal are to be weighed carefully in children, as these techniques are generally experimental.

If you want to preserve your fertility before cancer treatment or immediately thereafter, have a dialogue with your family physician, oncologist or a reproductive specialist

Your treating team will consider the type of cancer you have depending upon the biopsy report. The treatment plan and the amount of time you have before chemo-radiation is initiated helps to determine the best approach for your fertility preservation.

Obtaining information about fertility preservation methods before you start cancer treatment can help you take a well informed decision.

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