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HomeBlogPreserving Fertility – Life After Cancer Treatment

Preserving Fertility – Life After Cancer Treatment

11/6/2018 | By: Medix Team
Preserving Fertility – Life After Cancer Treatment

While Breast Cancer Awareness Month is over, it is important to raise awareness of Cancer year round and provide people with the tools to better navigate and manage their medical journey.


The recent Medix Medical Monitor study conducted in Hong Kong and Singapore showed that while Cancer remains the main concern of men and women alike, only about a third of the women undergo screening tests, such as a breast examination or pap smear.


With various fertility preservation techniques available, young women diagnosed with breast cancer have the option to maximise their chances of having children. Knowing what these options are plays a vital role in the possibility of conceiving in the future as well as improving emotional outlook going forward.

Advancements made in the last few decades in the detection and treatments of breast cancer have led to major improvement in the prognosis of this disease. Since the advent of the mammogram in 1966 and the adoption of it as standardised screening method by the early 1970’s, Five-year survival rates have increased significantly.

 

An estimated 16% of breast cancer cases are detected during women's childbearing years. Many treatment modalities such as chemotherapy, radiotherapy, surgical excision and/or hormonal therapy offer effective solutions in the fight against cancer; however, such modalities may have adverse side effects on fertility health. Thus the importance of receiving reproductive counseling at an early stage of diagnosis prior to undergoing cancer treatment is paramount in the success of fertility preservation.


Understanding the various techniques available

  • Ovarian stimulation and egg freezing (oocyte cryopreservation) – Daily hormone injections containing high levels of estrogen are prescribed to stimulate the maturity of the eggs within the ovaries. This process halts natural ovulation allowing a greater amount of eggs to be harvested in a shortened time frame prior to receiving cancer treatment. Following harvesting, these unfertilised eggs are then frozen. Frozen eggs can be stored for over 10 years. Ovarian stimulation has shown to have no significant negative impact on breast cancer treatment strategies as the time delay between the fertility technique and cancer treatment is brief.
  • Embryo freezing (cryopreservation) – This procedure uses ovarian stimulation to gather mature eggs. Once harvested these eggs are then fertilized with sperm via vitro fertilisation. Successfully fertilised eggs or viable embryos are then frozen. Research has shown that this method of fertility preservation has the highest possibility for success.
  • Ovarian tissue banking (cryopreservation) – This method of fertility preservation, still in its infancy, surgically removes a part or whole of the ovary containing a large amount of immature eggs. Once in the laboratory, the tissue is cut into strips and frozen. When the patient is in remission, the ovarian strips are taken out of cryopreservation and transplanted back into the body. Normal function of hormones and egg maturation within the ovaries are restored, enabling the possibility for conception. This technique allows for a large number of immature eggs to be gathered for future use and is a viable option for younger girls undergoing cancer treatment.
  • Ovarian suppression (ovarian ablation) – This technique involves the suppression of ovarian function by means of hormone therapy in order to protect eggs during cancer treatment. Following treatment, suppression is stopped and the ovaries return to normal function.
  • Ovarian transposition (oophoropexy) – This form of treatment is recommended for women undergoing radiation therapy to a pelvic tumor without chemotherapy. The laparoscopic procedure involves surgically repositioning the ovaries and fallopian tubes by attaching them to the abdominal wall, away from the radiation area in order to protect them from damage.

When considering fertility preservation, it is recommended that women consult with their treating Oncologist and a fertility specialist prior to starting cancer treatment. They will be able to guide you through the decision making process and prepare you for the challenges that may arise. 



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