Posts Tagged ‘cancer treatments’

Fertility Options Move Beyond Sperm and Embryo Banks

Cancer treatments such as chemotherapy and radiation can cause a woman to experience premature menopause and diminish her chance of getting pregnant. Similarly, chemotherapy, radiotherapy, or radical pelvic surgery can reduce a man’s ability to produce sperm.

In fact, 140,000 men and women younger than 45 years old face a cancer diagnosis each year.

But all is not lost for those who suffer from infertility caused by cancer treatments. Many survive treatment and are still young enough to have children.

There are ways to preserve a woman’s fertility, including freezing embryos, freezing her eggs, or freezing tissue from her ovaries before she goes for cancer treatment.

In the first and most effective method, a woman can undergo an IVF stimulation cycle, and the retrieved eggs can be fertilized with her partner’s or donor sperm.

The newly created embryos are then frozen with the anticipation that she will have the embryos replaced back to her uterus when she is cured.

That’s just what Ewelina and Dominic Saputo did.

Ewelina received a leukemia diagnosis when she was 23, and she and her then finance went through the process to create and freeze embryos, according to a recent Detroit Free Press article.

Six years later, the young couple from Sterling Heights, MI, just north of Detroit, went through an IVF procedure, and they now have twin, 10-month-old boys, Julian and Antonio.

For men, sperm collected before cancer treatment can be saved for many years.

World-renowned cyclist Lance Armstrong became a father for the fourth time after his sperm were preserved before his treatment for testicular cancer.

One of the innovative techniques available to men is to obtain tissue samples with a tiny needle and then use them to fertilize an egg stored for later use, which is called testicular sperm extraction.

The newspaper article includes a nice chart of simple or minimally invasive techniques available or coming soon to leading fertility programs for both men and women.

If you receive a cancer diagnosis, ask your oncologist how you can preserve your fertility.

New IVF techniques have taken fertility preservation to a whole new level.

Cancer Survivors Can Father Children

Men who have a zero sperm count from cancer treatments may still have a chance to father a child.

“We can usually retrieve sperm from the testicles of 30-50% of men who had chemotherapy even 15 or more years ago. Using ICSI, about 20% take home a baby,” write Weill Cornell Drs. Zev Rosenwaks and Marc Goldstein in A Baby at Last!

Sperm can be extracted using a procedure called microdissection testicular sperm extraction (TESE), a procedure that was developed by Weill Cornell researchers.

The procedure enables doctors to identify small areas in the testicles where sperm are made and then carefully extract these healthy sperm cells, even in men whose testicles have been severely damaged by chemotherapy. These sperm are then directly injected into a woman’s egg using an advanced in vitro fertilization (IVF) procedure called ICSI, which stands for intracytoplasmic sperm injection.

In a new study published online in the Journal of Clinical Oncology on March 14, Weill Cornell researchers report on more than 1,000 TESE procedures on nearly 900 men, including 73 cancer patients.

The researchers retrieved sperm in 27 (37%) of the cancer survivors, which led to the birth of 20 children using IVF techniques.

If you have cancer, the type of cancer and type of chemotherapy you receive affects your chances of successful sperm retrieval. For men with testicular cancer who received platinum drugs, the sperm retrieval rate was 85%. Men with lymphoma treated with an alkylating agent such as cyclophosphamide had lower retrieval rates, ranging from 26-36%. Sarcoma patients had the lowest retrieval rate, only 14%.

“When we started this study, we thought sperm retrieval rates would be close to zero among the group of cancer survivors, but we were surprised to discover that in many cases small areas of testicular tissue survived and resumed sperm production over a period of several years,” said lead author Peter Schlegel, MD, chairman of the Department of Urology at Weill Cornell Medical College, in a press release about the study.

“This study gives men a new way to achieve fertility and the potential of parenthood. Survivors of childhood cancer should be made aware of options besides using banked sperm, adoption or donors if they want to be fathers,” noted Lisa Diller, MD, Associate Professor of Pediatrics, Harvard Medical School, in the release.

Because the numbers of sperm retrieved from the testicles of cancer survivors are low, TESE is best performed at the time of egg retrieval so that fresh sperm can be immediately injected into the egg using ICSI. Any extra sperm can be frozen and preserved for future use.