Cancer and Fertility

So as I have previously mentioned: I work in a very busy fertility clinic in Harley Street. I've learnt lots about fertility and I get very excited when our patients come back with positive pregnancy tests. I love meeting the babies we help create and seeing how happy our patients are when their dreams come true.

I have decided to combine my day job with my voluntary work and do a post about cancer and fertility. It's a huge subject but it doesn't get much attention. More and more people are surviving cancer and I think it's awful that a lot of them will lose their fertility and not know about it. I'm working a a few projects to help cancer patients with their fertility and will let you know more as soon as my plans come to fruition! The NHS is not always able to freeze eggs or sperm; there is certain criteria patients have to meet but private clinics will allow you to freeze and preserve your eggs/sperm until you are ready to use them.

It is hugely important for you to discuss your risk of infertility before embarking on your treatment. If you have a partner then it is important for them to be part of the discussion. It is important for you both to have all the information so you can work out your options together.

It is very important to note that although your periods may stop; it still may be possible for you to get pregnant during your cancer treatment. It is vital that you use reliable contraception when having sex whilst having treatment.  Cancer treatments can be harmful to foetuses and to the expectant mum so it is hugely important to avoid pregnancy whilst suffering from cancer.

·         Some cancer drugs cause infertility meaning you can’t have children naturally.

·         Whether your infertility is permanent or just temporary would depend on a number of factors: The type of chemo drugs you are using, your age, your cancer type

·         Many people do go on to have healthy children even after undergoing cancer treatment.

·         Cancer treatments can stop your ovaries working. This could be a temporary and only apply whilst you are undergoing chemo but for higher doses of chemo the effects will usually be permanent.

Temporary Infertility

If your infertility is a temporary side effect of your cancer treatment then your periods will become irregular or stop completely during your treatment. They will gradually go back to normal once you have finished your treatment. This can take about six months to a year.

Early Menopause/Permanent Infertility

If your fertility is a permanent result of your cancer battle then you may have an early menopause. Your periods will become irregular and then stop completely. You may also experience hot flushes, dry skin, loss of energy and sex drive, mood swings and vaginal dryness although your doctor may prescribe you HRT to reduce these symptoms. This will be given to you after your chemotherapy treatment although unfortunately it will not enable your body to start producing eggs again and cannot prevent your infertility.

Preserving your Fertility

It is more complicated for women to preserve their fertility then it is for men but it is possible and there are several options for you to consider including freezing embryos, eggs or ovarian tissue.

This will have to be done before you start your treatment and will involve you having to have some eggs collected. This process takes several weeks and it is important to get it done as soon as you possibly can so you can begin treatment for your cancer and have the best chance of fighting it.

Collecting your Eggs

Stage 1: One the first day of your period you will be given an injection to temoraily give your specialist control of your egg production

Stage 2: Your ovaries are stimulated with hormone injections to produce extra eggs

Stage 3: The eggs are collected with a needle which is inserted through your vagina (you can be sedated for this)

Embryo Freezing

If you have a partner and you are both happy to have embryos created then your egg will need to be injected with your partner’s sperm. For this to happen your partner will need to produce a semen sample. It is also possible for you to use a donor sperm sample if you are currently single or in a same sex relationship. The sperm and egg are put together in a petri dish to allow fertilisation. It is also possible for mature eggs to be stripped and directly injected with the sperm to promote fertilisation. This is known as ICSI. The embryos are then prepared for flash freezing by being dehydrated and undergoing anti freeze treatment. They are them vitrified by rapidly being frozen in liquid nitrogen

Egg Freezing

If you are currently single then egg freezing is also an option for you. Your eggs will be vitrified which will hopefully give them a higher chance of survival. The eggs are collected and are then dehydrated and treated with anti freeze to prepare them for flash freezing. They are then rapidly frozen in liquid nitrogen. They can then be thawed with a much reduced chance of having crystals form which will hopefully prevent damage to the chromosomes

Sperm Freezing

Sperm can be frozen with relative ease. It can be frozen for more than forty years and still normally be thawed successfully. Before undergoing sperm freezing you will have to undergo a few tests to make sure you are clear of any infectious diseases such as Hepatitus B and C or HIV. You will also need to give written and signed consent for your sperm to be stored. You will provide a fresh sperm sample which will be frozen and stored in a tank of liquid nitrogen. You will have to wait a miminum of six months before being able to thaw your sperm sample for use in fertility treatments.

Getting Pregnant After Cancer Treatment

It is recommended that women wait at least two years after cancer treatments have finished before becoming pregnant. This is because if your cancer is going to reoccur then it is most likely to happen within the first 2 years after your original diagnosis.  

Once those 2 years are up, and you are ready to start a family, you can look into various fertility treats such as IVF or IUI for you or your partner to become pregnant using your frozen samples. 

For more information about fertility treatments please contact www.londonwomensclinic.com or www.londonspermbank.com

For more information on how your cancer treatment will affect your fertility please visit www.cancerresearchuk.org or ask your specialist.