How Cancer Patients Can Take Steps Toward Parenthood
- When “The Bachelor” star Katie Thurston, 34, was diagnosed with advanced breast cancer, one of the first decisions she had to make with her husband was whether they should take steps to preserve their fertility since the pair was hoping to one day start a family.
- Thurston and their husband, Jeff, underwent in vitro fertilization (IVF), a process where the sperm and eggs are fertilized outside the body in a lab. They managed to produce two embryos that can be used via surrogacy in the future.
- Various cancer treatments, including chemotherapy and radiation, can affect both men’s and women’s fertility. IVF is among several options cancer patients can turn to if they have hopes of parenthood.
- Before undergoing cancer treatment, patients should speak 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.
“When first diagnosed with breast cancer, one of my early decisions was if I wanted to pursue IVF before starting treatment. Decision-making when it comes to #oncofertility is complex,” Thurston wrote in an Instagram post.
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Thurston and Arcuri spent nearly two weeks in vitro fertilization (IVF), a process where the sperm and eggs are fertilized outside the body in a lab. They harvested 17 eggs, but after attempts at fertilization, only two were turned into embryos. The couple has the option to have the embryos transferred to a surrogate at a later date if needed.
“Now that I have stage 4 breast cancer, pregnancy would be a risk for me, especially as someone with hormone receptor-positive (HR+) breast cancer (meaning it feeds off of hormones). So, in the future, we will pursue #surrogacy in hopes of starting our family,” Thurston explained.
Thurston and Arcuri are hoping for a successful cancer journey and to become parents in the future.
Resources on Fertility and Cancer
- Fertility Preservation After a Cancer Diagnosis
- After A Cancer Diagnosis: Getting Fertility Hormone Injections
- How Does Chemotherapy Affect Fertility?
- Fertility Breakthrough! A Breast-Cancer Survivor Gives Birth After Her Harvested Eggs Mature in A Lab
- Pregnancy and Fertility After Thyroid Cancer: What Patients Need to Know
IVF’s Role In Family Planning For Cancer Patients
Fertility struggles are a genuine concern among cancer patients, as certain cancer treatments can cause infertility. Fortunately, in many cases, efforts can be made before beginning treatment to help preserve fertility.
Even without a diagnosis, many couples, at one point or another, experience infertility. The Centers for Disease Control and Prevention (CDC) says within the U.S., “about one in five” married women between the ages of 15 to 49 with no prior births are unable to get pregnant after trying for a year. Additionally, “one in four” of women in this group struggle to get pregnant or carry the pregnancy to term.
WATCH: How does chemotherapy affect fertility?
Infertility can be a side effect of cancer treatment due to how it impacts the body. Various cancer treatments, including chemotherapy and radiation, can affect both men’s and women’s fertility. Before undergoing cancer treatment, patients should speak to their doctors about fertility preservation if they wish to have a family in the future.
Patients should also recognize that infertility is a problem that affects so many people hoping to be parents, and nothing to be ashamed of.
The American Psychological Association said in its Monitor on Psychology Magazine, “A diagnosis of infertility — the inability to get pregnant after a year or more of trying — can lead to depression, anxiety, and other psychological problems, trigger feelings of shame and failure to live up to traditional gender expectations and strain relationships.”
Among men, infertility can “cut into a man’s feelings of masculinity” and “can lead to issues of shame and embarrassment,” psychologist William D. Petok told the outlet.
Cancer’s Impact on Male Fertility
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 lead to lower sperm count and testosterone levels, impacting fertility.
Possible side effects of cancer treatment should be discussed with your doctor before starting treatment. Men may have the option to store their sperm in a sperm bank before treatment to preserve their fertility.
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This sperm can then be used later as part of in vitro fertilization (IVF).
WATCH: Dr. Terri Woodard explains fertility preservation options patients have when going through cancer treatment.
Cancer Treatment’s Impact on Fertility in Women
Just as cancer treatment can impact men’s fertility, women may also be affected. Some types of chemotherapy can destroy eggs in your ovaries. This can make it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the type of drug and your age since your egg supply decreases with age.
“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 are having a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you for sure whether you will be impacted. 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 who preserve their fertility before cancer treatment do so by freezing their eggs or embryos.
After you finish your cancer treatment, a doctor who specializes 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 your eggs to create embryos in vitro and transfer them to your uterus or a surrogate later on.
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 right away and don’t have time to harvest eggs.
- Ovarian suppression prevents the eggs from maturing so they cannot be damaged during treatment.
- Ovarian transposition, for women getting radiation to the pelvis, moves the ovaries out of the line of treatment.
In addition to preserving eggs or embryos, 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 To Ask Your Doctor
If you’re wondering how your cancer treatment may affect your fertility and what options are available to you, the National Cancer Institute recommends asking your doctor these questions:
- Could my treatment lead to infertility?
- Are there other recommended cancer treatments that might not cause fertility problems?
- Which fertility preservation options would you advise for me?
- What fertility preservation options are available at this hospital? At a fertility clinic?
- Would you recommend a fertility specialist (such as a reproductive endocrinologist) I could talk with to learn more?
- What are the chances that my fertility will return after treatment?
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