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Archive for the ‘cancer and infertility’ tag

Fertility-Saving Options for Breast Cancer Patients

By Tracey Minella

October 2nd, 2012 at 8:11 pm


October is Breast Cancer Awareness Month.

The movement to remind women to get mammograms is in full swing.  Pink… the color for breast cancer awareness… is everywhere. It is no longer taboo to talk about breasts! Silicone bracelets proclaiming “Save the Tatas” and “I Love Boobies” have been spotted on the wrists of young and old alike.

Society’s newfound comfort with the word “breast” …and its slang…is evidence of how far breast cancer awareness has come. And it offers hope that the infertility awareness campaign will someday join breast cancer in terms of public awareness, funding, and support. If we can openly talk openly about breasts, can ovaries be far behind?

When you’re trying to conceive and you can’t, and then you go to a fertility specialist for help, and it still doesn’t happen, some women might think their life is over. That nothing could be worse. That no one has it harder than they do. Some may even feel that there’s no reason to go on if they can’t have a baby.

That probably sounds melodramatic to anyone who hasn’t faced down infertility… who hasn’t faced the possibility that the most maternal of our instincts, desires, and needs could be denied. But while the infertile woman is absolutely justified in feeling the whole range of emotions that accompany her diagnosis, things could actually be worse.

“What could possibly be worse than being infertile?” you ask.

You could have breast cancer.

It wasn’t all that long ago that a breast cancer diagnosis, with its accompanying chemotherapy and/or radiation, meant the end of a woman’s dream of having a biological child. The focus…and rightly so…was on saving her life. Not her breast. And certainly not her fertility.

Today there are more options for women. Now, women may have the chance to freeze their eggs or embryos prior to undergoing chemo or radiation or prior to surgically removing their ovaries. By doing that, women may be able to preserve their fertility for a future time when their breast cancer…or any cancer… crisis is behind them.

Although some breast cancer survivors do not undergo chemotherapy or radiation and, accordingly don’t compromise their fertility, many women do need these more aggressive cancer treatments. Thanks to egg and embryo freezing now, and IVF and embryo transfers later, more breast cancer survivors will be able to enjoy the post-cancer miracle of giving birth to a biological child.

Hopefully most oncologists and primary care doctors would refer young, newly-diagnosed cancer patients who have yet to start or complete their families to a reproductive endocrinologist for a consultation prior to chemotherapy or radiation or oophorectomy if time permits. If not, it’s an omission that can’t be remedied later.

Even if the referral is recommended, can a newly-diagnosed cancer patient even wrap her head around saving her fertility when she fears for her life? And if so, does her particular cancer allow her the time to explore this option? And what about teens whose health care is effectively still in the hands of their parents? Will the parents even think about their “baby’s” future fertility in the chaos of living through a parent’s worst nightmare?

It’s up to all of us to help spread the word about fertility-saving options so no woman who beats cancer has to find out afterward that she can’t become pregnant using her own eggs. So, file this information away and hope you never need to use it:

If any female you know (except post-menopausal women)…even a teen… is ever diagnosed with breast cancer, tell her or her spouse or parent to consider consulting  a reproductive endocrinologist before having chemotherapy or radiation or before removing her ovaries, if her cancer treatment protocol can accommodate the delay. You just might save her fertility. Of course, any post-menopausal woman diagnosed with breast cancer and any woman who did not pursue fertility preservation efforts prior to undergoing chemotherapy and/or radiation could explore conceiving with donor eggs or embryos after her treatment ends.

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Do you know of anyone who preserved her fertility prior to cancer treatment? Would you be able to share this information with someone diagnosed with cancer?

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Could You One Day Be Your Own Egg Donor?

By David Kreiner MD

August 30th, 2011 at 10:54 am

We are approaching a time that freezing eggs will be a standard option for an IVF program much like Embryo freezing is today.  Despite the fact that hundreds of babies have been born apparently without an increase in defects or abnormalities, the American Society for Reproductive Medicine (ASRM) has proclaimed that Egg freezing is still considered experimental.

This is not just a scientific decision but is a philosophical and political one as well.  In the 1980’s, IVF was being performed likewise on an experimental basis.  Insurance companies denied that it had become standard of care until recently.  In fact, there are insurance providers who in an effort to deny claims continue to call IVF experimental despite the million babies already born without significant increases in abnormalities or defects noted.  However, the ASRM is afraid to push the envelope and take a risk that may make them appear to be promoting a procedure that could theoretically be associated with increased problems with the children created after egg freezing.

But why should we be interested in egg freezing anyway when we have IVF that is successful and known to be relatively safe after 33 years of experience?  The reasons are multiple. 

A young woman who develops cancer and will have radiation therapy or chemotherapy that may affect her eggs or have her ovaries removed would with egg freezing have an option to preserve her fertility and still have her cancer treated. 

In the past, the loss of a woman’s future ability to bear children was sometimes more emotionally depressing for her than the cancer itself.  The prospect of offering hope to such affected women is spreading throughout the community in part through the efforts of the Lance Armstrong Fund supported group, Fertile Hope.  They are attempting to educate not just affected individuals but oncologists and other physicians who come into contact with patients who may be able to take advantage of new IVF technologies to preserve their fertility while undergoing cancer treatment.

Another great potential use for frozen eggs is in the donor egg program.  Currently, our egg donors go through fresh IVF cycles coordinated in time with the recipients so that the eggs are fertilized fresh when they are retrieved.  This is highly successful in achieving pregnancies in approximately 80% of donations.  However, cycles can be delayed in trying to synchronize patients.   If programs can achieve similar success rates using frozen eggs it will allow recipient patients to choose donor eggs much like they select donor sperm today.

Yet, another benefit of the ability to bank frozen eggs is for women who either because of their career or lack of finding a suitable partner need to put off their childbearing until a time when they would otherwise put their future fertility at significant risk.  This is a more controversial use of this technology but a practical concern for countless women today for whom conceiving before age 35 is unrealistic.

Needless to say, egg freezing will be a great benefit for many when it becomes a safe acceptable IVF standard.  That time for consideration by patients is rapidly approaching and is something that the public needs to be made aware of.

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If faced with one of the above situations, and a clinic who would offer it, would you choose egg-freezing even though the ASRM considers it experimental? Why or why not?

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