Tuesday, August 21, 2012

Cancer and Fertility: Is Cancer Going to Ruin Your Chance to Have a Baby?


A woman’s darkest moment is the day she is diagnosed with cancer. Further exacerbating the dire situation is her fear that she will never be able to have a baby because of the cancer and its subsequent treatment.
 This is a genuine concern. However, there are ways that a woman’s fertility can be conserved even though she is afflicted with cancer and receiving treatments, such as chemotherapy and/or radiation.
 When a female child is born, she possesses all of the eggs that she will ever have. As the woman ages, the number of viable eggs decline. That is why it is more complex for an older woman to get pregnant than a younger woman.
 Undergoing treatment for cancer can further diminish the number of eggs that a woman has and, additionally, the treatment may hasten the onset of menopause. Menopause is the time in a woman’s life when she stops menstruating and is no longer capable of getting pregnant. She is no longer in her “child-bearing” years.
 The type and dosage of treatment that a female cancer patient receives has a huge impact on her future fertility. This applies particularly to women that are over 35 years of age when they undergo the treatment.
 Reproductive medicine, which deals with a woman’s or man’s ability to have children, has come a long way. It the past, a woman’s chance of achieving a pregnancy after undergoing chemo and radiation was nil. It is possible to preserve the fertility of a woman who is on the precipice of cancer treatment, which is extraordinary news.
 There are several options which a woman needs to consider if she is determined to achieve a pregnancy post cancer treatment.

FREEZING EGGS
 There are various ways to preserve fertility including freezing the oocyte, which is the woman’s egg. This is done prior to the cancer treatment. The woman’s physician will kindle the woman’s ovulation. The physician may use a medication such as Clomid, which is an oral medicine, to motivate ovulation.
 Ovulation is the release of the ovum or the ripe egg from the woman’s ovary. Ovulation takes place when the cavity surrounding the follicle breaks open because the woman’s hormones have instructed it to do so. The egg is then released. This process generally takes place in the middle of a woman’s menstrual cycle. Once the egg or ovum is released it travels into the fallopian tube and is up for grabs. It is free to be fertilized.
 When medication is used to stimulate ovulation it allows the physician to time the ripening of the egg, which increases the probability of retrieving multiple eggs. When the woman is actively ovulating, the eggs are retrieved. Generally, numerous eggs are harvested (retrieved) and then frozen so they can be used later. This method is sometimes referred to as ovulation induction.
The reason the doctor collects many eggs is because some of the eggs will not develop or fertilize. The more eggs retrieved the better the chance that a pregnancy will ultimately result.

EMBRYO FREEZING
 Another option is embryo freezing. The eggs are retrieved from the woman and are then fertilized using in vitro fertilization (IVF.)
 IVF is essentially the process of physically combining an egg with sperm in a lab dish. The embryo is later transferred back into the woman, by placing the embryo in the uterus. A frozen embryo produces satisfactory pregnancy rates.
 If the cancer patient does not have a male partner to fertilize the egg then she can opt for donor sperm, which can be acquired from a sperm bank. The woman does not know the identity of the donor. Or she may choose to get sperm from a friend.

IN VITRO MATURATION
 Another alternative is called in vitro maturation. This means that hormonal stimulation is not used or is utilized in a very restricted way. Undeveloped eggs are taken from the ovary and are grown in the lab until they reach the point of maturity. This process is still considered to be in the introductory stages.

FACTORS TO CONSIDER
 There are many factors that impact a woman’s fertility post-cancer treatment including the type of chemotherapy medicines that were used, their dosages and the woman’s age when she received treatment.
 A cancer patient that is younger than 30 has the best shot of achieving a pregnancy post chemotherapy.  Younger woman are more likely to produce fertile eggs despite having undergone chemotherapy. However, women who are closing in on menopause are less likely to become pregnant after cancer treatment because even without cancer treatment the odds are, even in a healthy but older woman, that she is less likely to be fertile.
 Women who undergo chemotherapy when they are age 40 or older may be thrown directly into menopause, which means that the woman can’t get pregnant.
 The chemo medicines that are minimally risky when it comes to fertility include Adriamycin (doxorubicin) and Platinol (cisplatin) whereas the chemo drug that has a greater chance of causing infertility is Cytoxan (cyclophosphamide.)

Talk to your physician. Ask every conceivable question you can think of and get answers before undergoing treatment. Emphasize that you want to preserve your fertilize. You and your doctor can come up with the best way to proceed. You are your own best advocate.
Samantha Trent writes for Fertile-Future, a company dedicated to helping women with issues related to cancer fertilityegg storage, and fertility preservation. 

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