For Cancer Patients
In the US alone, approximately 700,000 women are diagnosed with cancer each year, and up to 8% are women under the age of 40. With the advancements in cancer therapies, there are increasing numbers of young cancer survivors who receive treatment before having children. In fact, 1 in 250 adults are childhood cancer survivors (Horowitz 2009).
Chemotherapy and radiation therapy negatively affect fertility. These treatments may damage the eggs and uterus, leading to premature infertility. Therefore, the best chance for these patients to have children of their own is by fertility preservation prior to treatment. Our team works closely with your oncologist to ensure a safe and optimal fertility preservation plan.
Click here for more informationCancer statistics
Almost 1.7 million Americans are expected to be diagnosed with cancer in 2014. The 5 year relative survival rate for all cancers diagnosed between 2003 and 2009 was 68%, up from 49% in the late 1970s. (www.cancer.org).
What is more, an estimated 67,500 adolescent and young adults (ages 13-39) were diagnosed with cancer in 2010. (www.cancer.gov). The 5 year survival rate for these was 80-85% between 1999-2005 (Ries 2002), which means roughly 55,000 young cancer survivors are added to the US population each year. This increase in survival rates is reflective of the enormous advancements made in cancer treatments in recent years. Unfortunately, these life-saving therapies often negatively affect fertility. Treatments may damage the eggs and uterus, leading to premature infertility.
Affect of cancer treatments on fertility
Cancer treatments in women
A woman stops producing new egg cells around the 20th week of fetal life. What is more, the number of eggs in her ovaries steadily declines throughout her life, starting even before birth. Therefore, she can never replenish her pool of eggs. Most cancer treatments have some level of gonadotoxicity (i.e., they are toxic to ovaries and eggs). Radiation therapy can cause loss in ovarian function and hormone production. The degree and persistence of ovarian damage is affected by a women’s age, the field of radiation, and the dose that she receives.
Chemotherapy may result in follicular depletion, ovarian failure and chromosomal damage in the egg. This is also affected by the dose received, as well as the specific type of chemotherapy received. For a complete list of chemotherapy agents and their level of gonadotoxicity, click here
Level of Gonadotoxicity of chemotherapy agents
| Unknown | Low | Medium | High |
|---|---|---|---|
| Taxanes | Methotrexate | Cisplatin | Cyclophosphamide |
| Oxaliplatin | 5-Fluorouracil | Adriamycin | Chlorambucil |
| Monoclonal antibodies | Vincristine | Melphalan | |
| Tyrosine kinase inhibitors | Bleomycin | Busulfan | |
| Actinomycin-D | Nitrogen mustard | ||
| Procarbazine |
References
1.Lee SJ, Schover LR, Partridge AH, et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol. 2006;24:2917-2931.
2.Oktem O, Urman B. Options of fertility preservation in female cancer patients. Obstet Gynecol Surv. 2010;65(8):531-542.
Cancer treatments in men
Unlike women, men continue to produce spermatozoa throughout life. However, during fetal life, the precursors to sperm cells (called spermatogonia) are established in the testicular tubules where they reside for the rest of a man’s life. When these precursor cells are damaged, it may result in male infertility. Radiation and chemotherapy may cause damage to spermatogonia as well as the cells responsible for producing testosterone, leading to male reproductive failure.
Infertility later in life can have severe psychological impact on survivors, affect their overall mood, and cause post-traumatic stress disorder even 10 years after treatment (Schover 2009). Unfortunately, many men and women are still unaware of the infertility risk associated with cancer treatment and the precautions that may help preserve fertility. At Colorado Fertility Preservation, we strive to give cancer patients the best chance possible to have children of their own in the future.
References
Horowitz ME et al. J Oncol Pract. 2009;5(3):110-112.
Ries L. SEER Cancer Statistics Review, 1975-2002. Bethesda, MD: National Cancer Institute; 2005
Schover LR. Patient attitudes toward fertility preservation. Pediatr Blood Cancer. 2009;53:281-284.