Despite Fertility Concerns, Options Exist for People Diagnosed With a Disease or Cancer
- “America’s Got Talent” star Madilyn Bailey, 31, enjoys parenthood alongside her husband to their adorable baby girl. Before her baby was born, she faced fertility challenges after an endometriosis diagnosis, which impacts fertility. She became pregnant with the help of in vitro fertilization (IVF).
- Endometriosis occurs when tissue similar to the tissue that normally lines the inside of the uterus, known as the endometrium, grows on the outside of the uterus. It often brings debilitating pain and can often be difficult to diagnose. A byproduct of this disease is infertility.
- Among cancer patients, fertility struggles are a fact of life because certain cancer treatments, including chemotherapy and radiation, can affect both men’s and women’s fertility.
- It’s recommended that before undergoing cancer treatment, patients talk to their doctors about fertility preservation if they wish to have a family in the future.
- Egg, sperm, and embryo freezing are common approaches to fertility preservation, but other options exist.
“America’s Got Talent” star Madilyn Bailey, 31, relishes her music career, but she cherishes being a mom to her daughter Bobbie even more. Bailey’s journey to motherhood wasn’t an easy path, as she and her husband experienced fertility struggles after she was diagnosed with endometriosis.
Endometriosis occurs when “tissue similar to the lining of the uterus grows outside the uterus,” according to the Office of Women’s Health. It affects mostly women in their 30s and 40s and can impact their fertility.
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“Singing to the baby I thought I’d never have,” Bailey said in a caption as she sang “What a Wonderful World” to her adorable daughter snuggled in her arms.
Bailey and her husband, Jimmy, share numerous cherished moments with their baby girl.
Bailey resorted to in vitro fertilization (IVF), a procedure in which a woman’s egg is fertilized with sperm in a lab. The embryo is then transferred to a woman’s uterus to develop. She discovered she was pregnant while shooting cover art for her debut album “Hollywood Dead.”
“I got the laparoscopic surgery, and then we decided we were going to start IVF,” Bailey said, according to People Magazine.
Bailey underwent hormone therapy to treat endometriosis, all while doing IVF.
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Hormone therapy is a common treatment for endometriosis. It is also used to treat cancer. Hormone therapy can “block the body’s ability to produce hormones” and can “interfere with how hormones behave in the body,” the National Cancer Institute (NCI) says.
“What’s interesting about doing IVF when you have endometriosis is the IVF medications that grow the eggs also grow your endometriosis. So, it kind of makes it worse at first,” Bailey said.
Understanding Endometriosis
According to the U.S. Office on Women’s Health, endometriosis happens when “tissue similar to the lining of the uterus grows outside of your uterus and on other areas of the body where it doesn’t belong.” The body parts affected by endometriosis may also include the ovaries and fallopian tubes.
The condition is often described as very painful. Women impacted may experience painful menstrual cramps, lower back and pelvic pain, and pain during or after sex. Bowel movements may also cause pain. Other symptoms include bleeding or spotting, digestive problems, and infertility.
Is Endometriosis Associated with Endometrial Cancer?
Research published in E Cancer Medical Science in 2018 studied the two conditions for a cancer link and found no evidence of a significant link.
Endometriosis is often found on the “ovarian, fallopian tubes, tissues that hold the uterus in place and the outer surface of the uterus.”
According to the National Cancer Institute, endometrial cancer (also called uterine cancer) begins when cancerous cells form in the tissues of the endometrium or lining of the uterus. Symptoms typically associated with this type of cancer include vaginal bleeding and pelvic pain.
After a woman has been diagnosed with endometrial cancer, her doctor will stage the cancer based on its spread within the body. A pelvic exam and imaging tests help your doctor learn if the cancer has spread or metastasized.
Researchers in the 2018 study noted that the “overall risk of endometriosis-associated cancer remains low.” They add, “In a large epidemiological study, the overall frequency of ovarian cancer arising in a patient with a diagnosis of endometriosis was 0.3 to 0.8%.”
For doctors to confirm symptoms like Irwin experienced are indeed benign endometriosis growths and nothing malignant, they must perform surgery.
Dr. Lindsey Ford, a Gynecologic oncologist at Thomas Jefferson Health University Hospital, adds further context between the two conditions.
“While endometrial cancer can sometimes present with this kind of pain, the most common warning signs for those who are pre-menopausal are spotting between periods; heavy periods; or any other changes to the menstrual cycle…For those who are post-menopausal, any vaginal bleeding is a ‘red flag,’” Dr. Ford explained to Jefferson Health.
Helping Patients With Fertility Resources
Fertility Concerns Are Ever-present for Cancer Patients, but Options Exist
Cancer treatments like chemotherapy can damage sperm in men, and hormone therapy can decrease sperm production, according to the National Cancer Institute. Radiation treatment can also lower sperm count and testosterone levels, impacting fertility. These possible side effects of cancer treatment should be discussed with your doctor before starting treatment.
In men diagnosed with cancer, they may have the option to store their sperm in a sperm bank before treatment to preserve their fertility. Their sperm can then be used later as part of in vitro fertilization (IVF), a procedure in which a woman’s egg is fertilized with sperm in a lab. The embryo is then transferred to a woman’s uterus to develop.
Among women diagnosed with cancer, some types of chemotherapy can destroy eggs in their ovaries, making it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the drug type and age since your egg supply decreases with age.
WATCH: Fertility preservation.
“The risk is greater the older you are,” reproductive endocrinologist Dr. Jaime Knopman told SurvivorNet.
“If you’re 39 and you get chemo that’s toxic to the ovaries, it’s most likely to make you menopausal. But, if you’re 29, your ovaries may recover because they have a higher baseline supply,” Dr. Knopman continued.
Radiation to the pelvis can also destroy eggs. It can damage the uterus, too. Surgery to your ovaries or uterus can hurt fertility as well.
Meanwhile, endocrine or hormone therapy may block or suppress essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.
If you have a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you whether you will have this side effect. That’s why you should discuss your options for fertility preservation before starting treatment.
Research shows that women who have fertility preserved before breast cancer treatment are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures.
Most women preserve their fertility before cancer treatment by freezing their eggs or embryos.
After you finish your cancer treatment, a doctor specializing in reproductive medicine can implant one or more embryos in your uterus or the uterus of a surrogate with the hope that it will result in pregnancy.
If you freeze eggs only before treatment, a fertility specialist can use sperm and eggs to create embryos in vitro and transfer them to your uterus.
When freezing eggs or embryos is not an option, doctors may try these approaches:
- Ovarian tissue freezing is an experimental approach for girls who haven’t yet reached puberty and don’t have mature eggs or for women who must begin treatment immediately and don’t have time to harvest eggs.
- Ovarian suppression prevents the eggs from maturing so they cannot be damaged during treatment.
- For women getting radiation to the pelvis, Ovarian transposition moves the ovaries out of the line of treatment.
In addition to preserving eggs or embryos, positive research has shown that women with early-stage hormone-receptor (HR) positive breast cancer were able to safely pause endocrine therapy (ET) to try to get pregnant, and they did not have worse short-term recurrence rates than people who did not stop endocrine treatment.
Questions for Your Doctor
If you’re wondering how your cancer treatment may affect your fertility and what options are available to you, consider asking your doctor these questions, according to the National Cancer Institute:
- Which fertility preservation options would you advise for me?
- What fertility preservation options are available at this hospital? At a fertility clinic?
- What are the chances that my fertility will return after treatment?
- Could my treatment lead to infertility?
- Are there other recommended cancer treatments that might not cause fertility problems?
- Would you recommend a fertility specialist (such as a reproductive endocrinologist) I could talk with to learn more?
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