1.
5 million men and women living in The US will be diagnosed with cancer in 2010, approximately 56,000 women before age 45 and 60,000 men before age 50.
If you are at risk for infertility because of cancer or cancer treatment, it is important to think about two sets of issues, personal and medical, before considering fertility preservation.
Female cancer survivors should also consider these factors especially if they were treated for estrogen sensitive cancer as breast cancer.
I.
Personal factor-what is the significance of parenting to you
Less than 50% of oncologists discuss fertility issues with their patients, according to national survey of oncologists.
An oncology nurse can also contribute to the discussion about cancer treatment and future fertility.
Ask for referral to a fertility preservation specialist.
In any case ask for reading material and scientific publication that discuss fertility preservation in your specific cancer.
II.
Medical Factor-risks, benefits and cost of fertility preservation * Is my ovarian reserve normal or diminished? Reduced ovarian reserve predicts decrease yield of eggs after ovarian stimulation.
* What is the success rate for different methods? Embryo freezing is more successful than egg freezing.
Egg vitrification appears to be superior to slow freezing method.
Women already treated for cancer with reasonable ovarian reserve, patent fallopian tubes and normal male factor can attempt pregnancy via timed intercourse or ovulation induction and intrauterine insemination first.
* How safe is ovarian stimulation in estrogen sensitive cancers? No evidence of harm so far.
* Is the delay in cancer treatment (average 3 weeks) acceptable to your oncologist? * If no current male partner would you freeze eggs or embryos (using donor sperm)? * What are the risks of pregnancy after cancer treatment, if not using a gestational carrier? There is no evidence of increased risk due to pregnancy after breast cancer treatment.
* What are the costs of the method used and are their support groups / insurance coverage to offset cost? Variable according to the method used.
Support from some national organization is available.
These issues are better discussed with a fertility preservation specialist together with your oncologist Listen to your physicians, ask for educational material then take few days to think about it.
Read more and discuss your options with family and loved ones.
There is no need to make an immediate decision.
5 million men and women living in The US will be diagnosed with cancer in 2010, approximately 56,000 women before age 45 and 60,000 men before age 50.
If you are at risk for infertility because of cancer or cancer treatment, it is important to think about two sets of issues, personal and medical, before considering fertility preservation.
Female cancer survivors should also consider these factors especially if they were treated for estrogen sensitive cancer as breast cancer.
I.
Personal factor-what is the significance of parenting to you
- Have I always wanted children?
- How many children do I want to have?
- Does it matter to me if my children are biologically related to me?
- Would I consider adoption to other parenthood options?
- How strong is my relationship to my partner?
- Am I open to using donor sperm or donor embryos?
- How does my partner or spouse feel about all of these issues?
- Do I have ethical or religious concerns about assisted reproductive technologies?
Less than 50% of oncologists discuss fertility issues with their patients, according to national survey of oncologists.
An oncology nurse can also contribute to the discussion about cancer treatment and future fertility.
Ask for referral to a fertility preservation specialist.
In any case ask for reading material and scientific publication that discuss fertility preservation in your specific cancer.
II.
Medical Factor-risks, benefits and cost of fertility preservation * Is my ovarian reserve normal or diminished? Reduced ovarian reserve predicts decrease yield of eggs after ovarian stimulation.
* What is the success rate for different methods? Embryo freezing is more successful than egg freezing.
Egg vitrification appears to be superior to slow freezing method.
Women already treated for cancer with reasonable ovarian reserve, patent fallopian tubes and normal male factor can attempt pregnancy via timed intercourse or ovulation induction and intrauterine insemination first.
* How safe is ovarian stimulation in estrogen sensitive cancers? No evidence of harm so far.
* Is the delay in cancer treatment (average 3 weeks) acceptable to your oncologist? * If no current male partner would you freeze eggs or embryos (using donor sperm)? * What are the risks of pregnancy after cancer treatment, if not using a gestational carrier? There is no evidence of increased risk due to pregnancy after breast cancer treatment.
* What are the costs of the method used and are their support groups / insurance coverage to offset cost? Variable according to the method used.
Support from some national organization is available.
These issues are better discussed with a fertility preservation specialist together with your oncologist Listen to your physicians, ask for educational material then take few days to think about it.
Read more and discuss your options with family and loved ones.
There is no need to make an immediate decision.
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