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Fertility Preservation Gains Momentum in Cancer Care as Awareness and Access Improve

a month ago4 min read

Key Insights

  • Cancer treatments including chemotherapy, radiation therapy, and surgery can severely impact fertility in reproductive-age patients, making early fertility preservation counseling essential.

  • Fertility specialists can now see patients within 24 hours of referral and complete preservation procedures within 2 weeks without delaying cancer treatment.

  • Advanced techniques like ovarian tissue cryopreservation offer options for patients who cannot undergo conventional egg freezing, including prepubertal girls.

Cancer treatments that save lives can come at a significant cost to future fertility, but a growing awareness among oncologists and advances in reproductive medicine are providing new hope for patients facing this dual challenge.
According to Katherine McDaniel, MD, reproductive endocrinologist at the University of Southern California and HRC Fertility, a significant number of cancer patients face treatments that can severely impact their fertility. Chemotherapy uses powerful drugs to kill cancer cells but can also damage reproductive organs, while radiation therapy targets and destroys cancer cells with high-energy rays, potentially harming the ovaries or testes. Surgery to remove organs crucial for reproduction, such as the uterus or other parts of the gynecologic anatomy, presents additional fertility risks.

Established Preservation Methods Show Promise

For women of reproductive age—typically up to 44 years old—who are anticipating cancer care that may affect their fertility, egg freezing, known as oocyte cryopreservation, represents the primary preservation option. In some cases, eggs can be combined with sperm to create and then freeze embryos. For male patients, sperm freezing offers a readily available and effective solution.
The landscape of fertility preservation has evolved significantly over the past decade. McDaniel notes that many patients with new cancer diagnoses simply weren't counseled on these options a decade or two ago, which was understandable as oncology teams focused primarily on treating the cancer and saving lives. However, there has been a substantial increase in awareness within the oncology community, leading to a significant rise in referrals to fertility specialists.

Advanced Techniques Expand Options

Beyond the core techniques of freezing eggs, embryos, and sperm, advanced methods are available for patients who aren't candidates for conventional approaches. Prepubertal girls cannot undergo egg freezing because their reproductive systems haven't fully matured. For these patients and others, significant pioneering work over the past two decades has led to ovarian tissue cryopreservation.
This procedure involves surgically removing an entire ovary or a portion of it, freezing the tissue, and then transplanting it back into the patient when they are ready to conceive, often many years or even decades later. This technique offers a vital lifeline for those for whom traditional egg freezing isn't an option.

Streamlined Care Prevents Treatment Delays

In alignment with American Society of Clinical Oncology (ASCO) guidelines, all patients of reproductive age should receive counseling on the potential impact of cancer treatments on their fertility. McDaniel emphasizes that timing is everything, with immediate referral to a fertility specialist being a priority the moment a cancer diagnosis is confirmed in a reproductive-age patient.
Fertility care clinics have adapted to the urgency of these cases, with providers understanding that cancer treatment plans often move rapidly. McDaniel and her colleagues strive to see patients within 24 hours of their referral, adjusting their schedules as needed to accommodate these time-sensitive cases.
One key advantage of modern fertility preservation is that it does not have to cause delays in cancer treatment. Specialists can often initiate the process on the very first visit, whether that involves egg/embryo freezing, sperm banking, or other fertility-preserving interventions. The entire process—from initial consultation to completion—can often be completed within 2 weeks, ensuring minimal disruption to the patient's cancer treatment schedule.

Collaborative Approach Improves Outcomes

The overall awareness of fertility preservation and the speed at which patients are referred to fertility clinics have both improved dramatically, offering more hope and options to individuals facing a cancer diagnosis. Reproductive endocrinologists and fertility experts recognize that every day counts and are committed to working collaboratively with oncology teams to ensure that fertility preservation does not become an obstacle to timely cancer therapy.
This collaborative approach represents a significant shift in cancer care, where preserving quality of life and future family-building options has become an integral part of comprehensive treatment planning for reproductive-age patients.
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