Oncofertility is a subfield of oncology and reproductive research that aims to maximize the reproductive potential of cancer patients and survivors. Different cancer treatments and surgeries can have an impact on an individual’s reproductive cells and anatomy, making it difficult to have children. Oncofertility allows for fertility preservation options, allowing cancer patients to grow their family in the future.

Cancer diagnosis and treatment can make childbirth more difficult or even cause uncertainty about having children in the future. Cancer treatments can also harm both men’s and women’s reproductive systems, impairing fertility for a variety of reasons, including:

• Radiation and chemotherapy – damage to a woman’s ovaries and uterus can impact her ability to conceive.

• Spermatogenesis – cancer treatments can affect the process of sperm production in men.

• Surgical treatments disrupting hormone levels needed for adequate reproductive function. Changes in hormonal levels can result in early menopause, damaged nerves, or dysfunctional sex organs.

• Surgical procedures removing reproductive organs required for fertility.

• Removal of tumors or tissue in or around reproductive organs.

• Surgical procedures performed on the abdominal, brain, and nervous system.

If you are a cancer patient who is also an aspiring parent, it is critical to discuss your prognosis and fertility goals with your preferred doctor(s) as early as possible. The preferred health care team may be able to plan a treatment that increases the chances of remaining fertile after cancer treatment or take proactive steps prior to treatment in preparation for fertility issues. If fertility is important to you, learning about the risks and available options before cancer treatment or surgery may be beneficial.

There are several ways to have a child after cancer treatment, including fertility treatment options such as:

Cryopreservation – Cryopreservation, done in conjunction with assisted reproductive technologies (ARTs), involves freezing sperm, eggs, and embryos for future use. This method is a safe and effective way for individuals to preserve their ability to have children after cancer treatments.

Sperm Cryopreservation – Sperm cryopreservation is a non-invasive, effective option for men who want to preserve their fertility. Men who have cryopreserved sperm and used intracytoplasmic sperm injection (ICSI) have a greater possibility of fathering a child in the future.

Embryo Cryopreservation – Embryos created through in vitro fertilization (IVF) are frozen and stored for later use. This method should be used prior to cancer treatment, and the sperm used to create the embryo must come from a willing partner or donor. The egg that was retrieved, fertilized, and cryoprotected will be thawed and used when the woman has completed cancer treatment and is ready to carry a baby.

Egg (Oocyte) Cryopreservation – Female patients who do not have a partner, do not want to use donor sperm, or are ethically or religiously opposed to embryo cryopreservation may benefit from egg freezing. Although eggs are susceptible to the physical and chemical damage caused by cryopreservation, as research advances, it is becoming a more viable option.

Every cancer patient and survivor has a unique history, circumstance, and fertility goal, so each oncofertility treatment plan will be tailored to reflect the individual’s specific needs. Oncofertility costs are determined by factors such as treatment recommendation, geographic location, physician and clinic experience/technique, and medical factors such as appointments, medications/fertility drugs, storage time of cryopreserved specimens, and assisted reproduction technology (if applicable).