What is Oncofertility?
Reproductive-aged men and women often deal with early onset cancer. Cancer and cancer treatments, such as surgery, chemotherapy, and radiation therapy, may impair the reproductive and hormonal system of the body and its ability to reproduce. For people hoping to have children, cancer diagnosis and treatment can derail their parenthood plans.
Oncofertility serves as a rescuer and acts like a bridge between oncologists and reproductive endocrinologists. Oncofertility, a subspecialty of medicine, bridges oncology and reproductive endocrinology to maximise the reproductive potential of cancer patients and survivors. It is also known as oncofertility preservation.
An oncofertility specialist can expand fertility options beyond embryo donation or gamete donation and consider having children with their own sperm or egg. They educate and empower parents while taking them through a range of fertility preservation options that can assist them make the best decisions for their families depending on their underlying health conditions.
Who Needs It?
Oncofertility is ideal for those young-aged, intending parents (both men and women) who have cancer or have to undergo a cancer treatment procedure, including chemotherapy, surgery, and radiation therapy.
For a woman, these cancer therapies can cause a range of reproductive issues like:
- Ovarian damage that can cause genetic damage to eggs,
- Premature Ovarian Failure leading to an early menopause
- Uterine lining damage or removal of vital reproductive organs.
Even in men, cancer treatments can cause a series of damage, including:
- Testicular damage resulting impaired sperm production and testosterone secretion.
Cancer treatments definitely improve survival rates but can affect fertility and reproductive health. Consult a reproductive endocrinologist at the earliest if diagnosed with cancer and optimise your chances of becoming a parent before chemotherapy, surgery, or pelvic radiation therapy.
Options For Fertility Preservation
Oncofertility opens windows to a range of fertility preservation options for both women and men.
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For Women
- Pelvic and Genital Shielding: A lead apron is used to shield the pelvic region and the genitals from the damaging effects of radiation. The lead apron acts as a shield and protects the ovaries and testicles.
- Ovarian Transposition: Here, the ovaries are surgically moved outside the pelvic region to minimise the damaging effects of the radiations on the ovaries.
- Gonadotropin Agonist Injections: Medications can chemically downregulate ovarian functions. Generally administered before chemotherapy. Experts believe that the low metabolic activities of the ovaries can cause minimal damage. However, gonadotropin agonist administration can also lead to permanent downregulated ovarian function.
- In Vitro Maturation (IVM): IVM of oocytes involves harvesting multiple immature eggs through ultrasound guidance. This method requires no hormonal stimulation as only immature eggs are retrieved and matured in the laboratory before or after freezing. The prime advantage of this procedure is that retrieval of immature eggs requires a short time that can minimise the delay of cancer therapy.
- Egg Cryopreservation: Here, the woman’s eggs are preserved for future fertilisation. After a hormonal stimulation procedure, multiple eggs are retrieved and preserved with the help of a cryoprotectant at sub-zero temperatures for future use or pregnancy.
- Donor Egg: In cases where the ovaries cannot produce viable eggs, one can consider egg donor options from another female. The donated egg is fertilised with the sperm of a male partner to form embryos that are transferred into the uterus for further pregnancy.
For Men
Along with pelvic and genital shielding and gonadotropin agonist injections, men have other fertility preservation options, such as:
- Sperm Banking or Sperm Freezing: The sperms are collected either through natural ejaculation or surgical sperm aspiration methods and cryopreserved for future use.
- Donor Sperm: In cases of low sperm count or poor quality sperm, sperm can be taken from another male donor. The retrieved sperms can be artificially inseminated into the female reproductive tract or can be fertilised through IVF or ICSI.
Other Alternative Options
- Embryo freezing: Before cancer treatment, one can fertilise the embryos formed from the couple’s gametes. For this, the woman goes through a hormonal stimulation procedure, and the gametes are retrieved and fertilised in-vitro. The developed embryos are frozen and preserved for future use or pregnancy.
- Ovarian and Testicular Tissue Banking: In this procedure, the ovarian cortex or testicular tissues are surgically extracted and frozen. The extracted tissue is transplanted back after the cancer treatment.
Difference Between Oncofertility & Fertility Preservation
Oncofertility is a form of fertility preservation option rendered when a person of his/ her reproductive age is diagnosed with cancer or is likely to undergo cancer treatment that can eventually impair fertility and reproductive health.
Oncofertility specialists bridge oncologists and reproductive endocrinologists to help with different fertility preservation options depending on the underlying cancer condition and treatment.
While fertility preservation options can be taken even by a person who hopes to have children in the future or have issues related to reproductive anatomy. Fertility preservation option chosen for purposes other than oncological treatments requires no oncofertility specialist intervention.
If you are looking for an oncofertility specialist or fertility preservation options, connect with us at Omya Fertility centre, your one-stop solution for all your fertility needs.