You and Me and Baby = Family

September 18, 2014
By: Anne Katz PhD, RN

While some young adults and most teens are not thinking about having babies (quite the opposite in fact!), having cancer at a young age forces you to think about your future fertility. Most AYAs with cancer have to deal with some really challenging stuff before starting treatment, and that includes thinking and talking about preserving fertility.

Many cancer treatments have a negative impact on your ability to make a baby in the future. Surgery to the organs involved in creating or growing a baby (testicles in guys and ovaries and/or uterus in women) may make pregnancy impossible, or at least very difficult. Radiation to the same organs or to the brain where the production of hormones is controlled can have a similar effect. Chemotherapy can push women into early menopause, limiting the time you have to get pregnant, or completely shut down your production of eggs forever. For guys the outlook is a little better: chemotherapy may cause a temporary shutdown of sperm production but you may recover in the future. But some guys never recover their full fertility.

It is VERY important to talk about fertility preservation before you start treatment. Most procedures need to be done before treatment starts and some require a delay in starting treatment. This may not be possible and everyone is different – but you should at least have the conversation with your oncology care providers very soon after diagnosis.

Options for fertility preservation:
· For guys – sperm banking. This is the easiest method and has been used for many years. Frozen sperm can be used years later.
· For girls – freezing eggs or freezing embryos (this requires a male partner to provide sperm or an anonymous sperm donor from a sperm bank at a fertility clinic).
These are the only non-experimental methods for preserving fertility. There is a lot of research in this area and changes happen often.

There are other options for those who have already had treatments that have affected their fertility, or where preservation was not possible. These include creating a family in other ways such as through adoption or a gestational carrier (having another woman carry a baby for you, using a partner’s sperm or eggs).

It is also important not to think that if you have had treatment you are automatically infertile (unable to create or carry a baby). You may still be fertile and an unplanned pregnancy can really turn your world upside down and inside out. If you are sexually active it is always important to think about protecting yourself and your partner from sexually transmitted infections as well as unplanned pregnancy. So contraception and safer sex remains very important for all AYAs with a history of cancer.

Web Sites

· Fertile Future is a Canadian nonprofit organization that provides fertility preservation information and support services to people with cancer as well as oncology professionals. www.fertilefuture.ca

· Fertile Hope is a national LIVESTRONGinitiative providing reproductive information, support, and hope to cancer survivors who are at risk for infertility. This organization is based in the US but has useful information for everyone. www.fertilehope.org

· The Oncofertility Consortium is a national, interdisciplinary organization involved in the care of cancer survivors and their reproductive health. www.myoncofertility.org

· SaveMyFertility.org, part of the Endocrine Society is a resource for people with cancer who want to learn more about preserving their fertility before and during cancer treatment. www.savemyfertility.org

· The American Society for Reproductive Medicine is the nationally and internationally recognized society for information, education, advocacy, and standards in the area of reproductive medicine. They have useful resources for patients. https://www.reproductivefacts.org

From This Should Not Be Happening: Young Adults and Cancer (Hygeia Media 2014; Used with permission)