What steps can a woman take to preserve her fertility before starting cancer therapy?
A woman's treatment options will depend on the type of cancer she has, the type of treatment she's going to receive, and how much time she has before starting treatment. If she's going to start therapy very soon, her only option may be a gonadotropin-releasing hormone agonist (GnRH), a medication that may ultimately preserve ovarian function by shutting down the ovaries during chemotherapy. Although unproven, it is believed that putting the ovaries to sleep during chemotherapy may actually protect them. Afterwards, ovarian function may return to normal or close to normal.
Another thing we sometimes do is freeze a woman's eggs or embryos before therapy. If she has a couple of weeks before the start of chemotherapy, we may discuss stimulating her ovaries, removing several eggs, and then either freezing the eggs or fertilizing them with male sperm and freezing the embryos. This is essentially the same as an in vitro fertilization cycle.
What factors affect a woman's chances of getting pregnant after she completes cancer therapy?
The most important factor is her age at the time that she's receiving chemotherapy. If she's in her late thirties or forties, it's less likely that her ovarian function will return to normal. In addition, the type of chemotherapy drug and the total dose are important. Some types of chemotherapy are much more damaging to the ovaries than other types.
If preserving fertility is a primary concern, a woman may request a type of chemotherapy that could have a less toxic effect on the ovaries.
