Fertility preservation helps cancer patients plan pregnancy post cancer treatment in Chennai
Posted on: 30/Aug/2018 5:13:55 PM
At the young age of 27, Kala (name changed), who had been married for three months, was diagnosed with non-Hodgkin’s lymphoma (NHL), a type of cancer that affects the immune system. Starting a family had always been a part of the plan for newly-married Kala and her husband, Rajesh. That is why, they were advised to freeze their embryos before Kala started her chemotherapy and radiotherapy. Embryos were formed using Kala’s eggs and Rajesh’s sperms and cryopreserved for use post the cancer treatment.
Cancer is a rising concern in India. A large number of men and women under the age of 40 are being diagnosed with various forms of cancer. This in turn is impacting their fertility in a big, often unnoticed, way. National Cancer Registry of India suggests that the annual number of patients who develop cancer in India is set to rise from about 9.79 lakhs in 2010 to 11.4 lakhs in 2020. There is now a growing population of young survivors who face quality-of-life issues, including the prospect of having a child post cancer treatment. Approximately 40-80% of females and males (cancer survivors) will face possible infertility as a result of cancer treatment unless intervened. This is when onco-fertility or fertility preservation comes to the rescue. Fertility preservation is an effort to help individuals retain their fertility or ability to conceive.
Chemotherapy and radiotherapy involve certain drugs and exposure to radiations, which can effectively kill cancer cells and prevent relapses, but may also cause damage to the gametes (i.e. eggs and sperms), causing difficulties in conceiving later. Fertility preservation gives hope to have a family after surviving cancer. Cancer patients have the option to freeze their eggs, sperms, or embryos (for married couples) prior to cancer treatment, so that if infertility unfortunately occurs, they can still conceive through IVF/ICSI when they are cured.
Dr. Madhupriya, Fertility Consultant at Nova IVI Fertility, Chennai said, “Though all types of cancer may not effect fertility, unless ovarian or testicular, the anti-cancer drug used during treatment can affect the ovaries and testes, and eventually reduce the reproductive capacity of women or men accordingly. As women are born with finite number of eggs, the treatment with chemotherapy and radiotherapy at times leads to complete or partial loss of fertility potential in women. In some cases, women may reach menopause immediately after chemotherapy, resulting in complete cessation of their monthly cycles. The effects of cancer treatment for men include complete shutdown of sperm production, compromised sperm count, motility, morphology, and DNA integrity.”
Since oncologists are generally the first of doctors whom patients visit to get a cancer screening, it is important to spread awareness among them initially. Oncologists have to explain how cancer treatment can affect the fertility potential and also discuss the options of fertility preservation with cancer patients before they start chemotherapy or radiotherapy.Fertility preservation is not only helpful for cancer patients but also for women who plan for late pregnancies. As women in their late 30s or in early 40s face difficulties in conceiving babies naturally, oocyte cryopreservation can help. This is also called social freezing.
“Fertility preservation is gaining impoportance in the life of cancer patients as well as those who wish to delay pregnancy for any reason, as it gives them a new hope even after their fertile years. In Chennai, we see 1-2 women coming forward every month to have their oocytes preserved. The best part about the technique is that the quality of the frozen egg or embryo remains intact even after many years,” added Dr Madhupriya.
Not every cancer patient will have the opportunity to preserve their fertility before chemotherapy or radiation treatment. There are many instances where it becomes too late for a cancer patient to take the decision of preserving the oocytes or embryos. For those not fortunate to have frozen eggs or embryos prior to cancer treatment and whose gametes have been completely depleted, IVF/ICSI with donor gametes is a common solution. Egg donation is often a successful treatment for infertility in women who can no longer produce healthy eggs, while men have the option of going for sperm donation. Embryo donation is suggested for couples where both partners are unable to produce viable gametes.
