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Jessica Thomas learned of her breast cancer diagnosis in July 2005. At 32, the diagnosis came as a shock to the otherwise healthy newlywed. Immediately doctors began talking about surgery, chemotherapy, prognosis and – oh, by the way – the treatments can cause infertility.
Jessica had four weeks to attempt fertility preservation before surgery and treatments commenced. She consulted Dr. Samuel J. Chantilis of Dallas/Fort Worth Fertility Associates. In short order, Dr. Chantilis administered the hormones to promote ovulation, egg maturation and eventually harvested her eggs, creating embryos and freezing them for future use. Jessica is not alone in this issue. While many cancer patients realize a cancer diagnosis comes with challenges, few realize one of those obstacles may be infertility.Perhaps, infertility is not as commonly associated with cancer in the minds of the public because no one wants to think about cancer occurring in the midst of the reproductive years, roughly ages 15-45. However, the average age of testicular cancer is 26, while 50,000 (or 8 percent of) women who battled invasive cancer in 2001 were under the age of 40. Of course, cancers in the reproductive organs present the highest risk for infertility and sterility; but cancer itself is not the only factor. Treatments, especially the alkylating agents in some chemotherapy regimens, can affect sperm production and ovary function.What are the options? Well, it depends.When it comes to gynecological cancers, the variables matter – and there are plenty of them. Depending on age and the severity of the cancer, fertility-sparing surgeries can be performed, allowing patients to retain at least some of the organs’ function. However, it is important to note these surgeries do not guarantee a woman will be able to conceive or carry to full-term. Dr. Noelle Cloven, a gynecologic oncologist with Texas Oncology Fort Worth, notices an increase in fertility issues and cancer patients. "Women are delaying child-bearing nowadays; a lot more women in their late 30s and early 40s are interested in becoming pregnant," he explained. "Fertility becomes an issue because some cancers, especially cervical cancer, can present in the early to mid-40s."If fertility-preserving surgeries are not an option, a female cancer patient can pursue information and treatment from a fertility specialist. According to Dr. Robert Kaufmann, medical director for infertility services at Andrews Women’s Hospital at Baylor All Saints Medical Center Fort Worth, three options exist in such cases: freezing embryos, freezing eggs and ovarian tissue cryopreservation. Of the three, embryo preservation is the most commonly practiced. Harvesting and freezing eggs is an emerging process, practiced in some locations, but is still under development. Ovarian transplantation, an extraction of ovarian tissue for freezing and later implantation, is in very early stages of practice, but has had some success.
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