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How Does Cancer Treatment Affect Fertility In Men And Women?

Every year on 4 February, World Cancer Day is celebrated to raise awareness about cancer and encourage its early detection, treatment and prevention. The survival statistics of cancer patients have increased in the past years due to lifesaving treatment methods like radiation, chemotherapy and surgery. These methods have known to cure a wide range of cancer by destroying the cancerous cells that tend to multiply at a faster rate. However, these methods have high side effects on cancer patients. [1] They can impair the reproductive system and endocrine health of the patient causing problems in their future fertility.

According to a report, there are around 15.5 million young adult cancer survivors (15-39) who are facing an important quality-of-life issue i.e. fertility. They too wish to have a baby but the reproductive risk postcancer treatment has is making them think about it. Here are the few points which will help you know about fertility after cancer treatment.

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Infertility in Women Due To Cancer

Women often face fertility issues after cancer treatment. It may be due to unhealthy eggs in the ovaries or damage of reproductive parts during the treatment that prevents the fertilization of eggs. However, there are certain things which must be considered before the fertility preservation in women and they are as follows:

  • If cancer in a woman is likely to metastasize to reproductive organs in the future.
  • When treatment of cancer cannot be delayed due to its fast-growing nature.
  • Chances of treatment success which is less in women above 40.

In most cases, women who already have a child/children do not receive information about preserving their fertility. Women who are intended to have children in the future can talk to their doctor about fertility problems and how to preserve them before the treatment. [2]

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Infertility in Men Due To Cancer

Cancer treatment methods can affect the fertility of a man either temporarily or permanently. Fertility problems in men due to cancer treatment can occur due to damage to endocrine organs like testicles, adrenal glands and thyroid glands. It can also occur due to change in the brain parts which are responsible for controlling the endocrine system. [3]

Due to the aforementioned treatment methods, the count of the sperm may go down leading to lower semen production. Also, cancer treatment methods may affect the neurons responsible for the function of testicles or other reproductive glands in men.

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Treatment Methods That Can Affect Fertility

Being aware of the side effects of cancer treatment is always a good idea. Some of the cancer treatment methods that can affect fertility are as follows:

  • Chemotherapy: Some chemotherapy drugs affect the reproductive system by damaging eggs or sperms. However, women aged below 35 has a good chance of getting pregnant by preserving their eggs beforehand. Men too can preserve their sperms before the treatment and father a child later with the help of his healthy female partner who can get pregnant with his sperms. [4]
  • Targeted cancer therapies: This treatment method uses high-energy rays to kill cancerous cells. It works by targetting the genes which are responsible for the growth, multiplication and spread of cancer throughout the body. [5]
  • Surgery: If cancer has spread to the reproductive organs like prostate, ovaries or testicles, a medical expert may suggest surgery or removal of that particular reproductive organ. This may cause permanent infertility in both men and women.
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How To Preserve Fertility In Women During Cancer Treatment

Women are born with a particular number of eggs in the ovaries. During the cancer treatment, the count of eggs usually goes down making it hard for a woman to conceive. The low eggs count is thus responsible for early menopause in women. That's why it is suggested to preserve fertility in below-mentioned ways if there's a risk of infertility in the future. [6]The methods are as follows:

  • Donor eggs: This method is carried out when a woman wishes to have a child after the treatment, but neither has her preserved eggs in the laboratory nor in her ovaries. In this case, she can get a donor, basically, another woman who wishes to give her eggs to the cancer-survivor woman. Later, those eggs are fertilized with sperms in the lab and transferred to the woman's uterus who wants a child.
  • In vitro fertilization (IVF): In this treatment method, a specific type of drug is given to women so as to stimulate their ovaries for the production of eggs that can later be fertilized in the lab with sperm and develop into an embryo.
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How To Preserve Fertility In Men During Cancer Treatment

According to the American Society of Clinical Oncology (ASCO), all men with cancer should consult their medical expert about their fertility preservation options. This depends on their age, willingness to have a child in the future, sexual maturity and relationship status. The options for preserving fertility include the following: [7]

  • Sperm banking: The process in which sperms are frozen and stored before the treatment to be used later. The process includes Vitro fertilization and intrauterine insemination.
  • Testicular-tissue freezing: This treatment method is for young boys who have not reached puberty. In this process, some portion of testicular tissues which are responsible for producing sperms are removed followed by freezing and storing them for later use.
  • Shielding testicles: This treatment method can be carried out just before the treatment begins. It is carried out by shielding the pelvic area (especially the reproductive area) from radiation.

Risks

  • Recurrence of cancer
  • Passing of cancer to the child
  • Chances of uncertainty (If cancer returns causing the death of a person, the other partner should be prepared to raise the child as a single parent)
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