A person’s fertility during and after a cancer diagnosis is associated with cancer survivorship, especially for those patients younger than 30 years. With long-term survival rates, they will inevitably face reproductive issues because some types of cancer treatments, such as chemotherapy and radiation therapy, may cause temporary or permanent infertility.
Influence of cancer treatment on fertility
If a female cancer survivor want to conceive spontaneously, she will require sufficient ovarian follicular reserve, a uterus that supports a developing fetus, and functional organ systems. While cancer and related treatments can potentially disrupt any aspect of this delicate balance and limit a patient’s reproductive potential.
Treatment-related infertility is reported to be significantly related with survivors’ quality of life. For some patients, physical changes make it more difficult to conceive a child, even leading to a complete, permanent loss of fertility. Thus younger cancer patients struggle to identify themselves as normal, or the potential for future fertility, and then feel relaxed. In this context, a fertility preservation consultation may be a source of hope.
Tackle fertility issue
Appropriate patients are referred to fertility specialists for further counseling and fertility preservation. The standard practice investigators take is the cryopreservation of sperm, oocyte, and embryo according to existing guidelines. Since a decline in vitro fertilization (IVF) outcomes following cancer treatment is well documented, it is imperative to the success of fertility preservation that embryos or oocytes are preserved prior to the initiation of cancer treatment.
Both embryos or oocytes cryopreservation require the use of IVF, which enables patients to potentially take advantage of preimplantation genetic diagnosis (PGD), a method of screening embryos or oocytes for genetic abnormalities before transfer into the uterus. While most cancers arise sporadically, 5% to 10% of cancer diagnoses are inherited through currently recognized genetic cancer syndromes.
Hereditary Cancer Syndromes for Which PGD Has Been Used to Identify Affected Embryos
References :
1. Fertility issues in cancer survivorship. CA: A Cancer Journal for Clinicians. 2014; 64( 2):118–134
2. Highly penetrant hereditary cancer syndromes. Oncogene. 2004;23:6445-6470.