Programs and Services

Preserving Fertility for Women With Cancer

A diagnosis of cancer brings many important decisions into a woman’s life. While chemotherapy, radiation and surgery can effectively treat cancer, these treatments may also affect a woman’s fertility. Women undergoing treatment for other diseases (such as lupus) and certain autoimmune disorders (such as rheumatoid arthritis) also risk losing their fertility.

But these treatments don’t have to end a woman’s or even a young girl’s hopes of having a family. Today, women with cancer and other diseases have many options — before and after treatment.

How Cancer Treatments Can Affect Fertility

For women undergoing radiation treatment to the lower abdomen, there is a risk that the radiation could damage or destroy their ovaries, depending on the size and location of the tumor and the radiation dosage prescribed. When ovarian function is damaged or destroyed, women stop producing female hormones, go into menopause and lose their ability to bear children.
Depending on the woman’s age, the type of chemotherapy prescribed and the dosage, chemotherapy can damage or destroy ovaries while destroying the cancer.
With cancers that affect the female reproductive organs, the best treatment option may be surgery to remove those organs.

Fertility Preservation Techniques

New techniques are providing hope for preserving or restoring fertility in girls and women after cancer treatment. At Froedtert & the Medical College of Wisconsin, reproductive specialists, geneticists, oncologists, nurse specialists, laparoscopic surgeons and obstetricians/gynecologists work together to offer the following options:

Ovarian tissue banking — Froedtert & the Medical College of Wisconsin were among the first in the country to offer this experimental treatment, which shows promise for some women. Using laparoscopy (minimally invasive surgery), a small amount of ovarian tissue is removed. The tissue is frozen and stored until you and your physician decide the best time to re-implant it. Ovarian tissue banking has produced fertilized embryos and has also resulted in successful pregnancy. Producing a child by this technique may require additional medical intervention, such as in vitro fertilization. Because this treatment is conducted as a clinical study, you must meet specific eligibility requirements to be considered for ovarian tissue banking.

The ovarian tissue banking program at Froedtert & the Medical College of Wisconsin is overseen by Gloria Halverson, MD, Medical College of Wisconsin Obstetrician/Gynecologist. The Medical College of Wisconsin is a member of National Physicians Cooperative (NPC) of the Oncofertility Consortium. This is a national, interdisciplinary initiative to explore and expand options for the reproductive future of cancer survivors. It is supported by the National Institutes of Health Interdisciplinary Research Consortium Grant (NIH Grant: U54RR024347).
Medication — If chemotherapy would damage a woman’s ovaries, a medication may be used to temporarily shut down ovarian function, making them less susceptible to the chemotherapy drugs.
In vitro fertilization (IVF) — This technique involves the fertilization of a woman’s eggs outside of her body — in a glass laboratory dish. Sperm provided by the male is mixed with eggs that have been removed from the woman’s ovaries. For a woman undergoing chemotherapy or radiation, the fertilized eggs (embryos) also can be frozen. At a future time, the frozen embryos can be transferred to the woman’s uterus, with the hope that pregnancy will occur. Ideally, preparation for harvesting of eggs for IVF should begin at least six weeks before chemotherapy or radiation begins.

Depending on the fertility problem, the eggs used in IVF may be the woman’s own eggs or donor eggs from another woman.
Ovary transposition — To prevent damaging the ovaries if radiation therapy is needed, the precise area of the body that will receive the radiation is determined. If it appears the ovaries would be adversely affected by the radiation, surgery can be performed to move the ovaries out of the way of the radiation beam.

If you would like more information, please visit these Web sites:

http://www.fertilehope.org/

http://myoncofertility.org/

Talk to your physician(s) about your treatment and how it may affect your ability to have children.

We will be happy to answer your questions related to preserving fertility for women with cancer and other fertility concerns. Please contact us.

Frequently Asked Questions

Which fertility preservation option is best for me?
Only you and your doctor can decide. The effects of cancer treatment vary depending on the type of chemotherapy you receive or the intensity of your radiation therapy, and the number of eggs remaining in your ovaries before treatment.
If I become pregnant after having cancer, is there a risk that the baby will get cancer?
This is rare, and is seen only when a woman has a genetically inherited type of cancer.
If I become pregnant after having cancer treatment, is there a higher risk of birth defects for my baby?
No. If an egg was able to be fertilized, it’s a healthy egg.
If I get pregnant after having cancer, will the hormones associated with pregnancy cause my cancer to return?
No. Studies show that there is no increased risk of cancer returning if you have a baby.
If I already had chemotherapy and/or radiation and I’m sterile, is there anything that can be done to have a child?
You may wish to consider assisted reproduction therapy methods such as in vitro fertilization or intracytoplasmic sperm injection (ICSI) using donor eggs. These services are available through the Reproductive Medicine Center at Froedtert & the Medical College of Wisconsin.

Author: Marla Fraunfelder

Last Review Date: Oct. 27, 2008

Online Editor(s): Christopher Sadler