Fertility Care for Cancer Patients

OncoFertility refers to the medical field that bridges the specialties of oncology and reproductive endocrinology with the purpose of maximizing the reproductive potential of cancer patients and survivors.

Cancer treatments can negatively affect an individual’s ability to reproduce. They can impact an individual’s reproductive cells (sperm or eggs) and anatomy and hence their ability to have children. With cancer survival rates increasing, fertility preservation has become a relevant consideration for individuals receiving cancer therapies.

For many younger cancer survivors, this means talking about fertility preservation upfront so that they will have the option to grow their family in the future. It is important that patients discuss those options with their doctor and make a fertility preservation plan.


Infertility & Cancer Treatment

Cancer and its treatments can damage the reproductive system, causing fertility problems for both men and women. For example:

There are many ways to have a child after cancer treatment, including fertility treatments using cryopreserved sperm, eggs or embryos; surrogacy, egg or sperm donation, and embryo adoption and adoption.

If you are a cancer patient who is also an aspiring parent, it’s important to talk to your doctor about your prognosis and—if you are a woman—how safe it is for you to become pregnant.

Treatment Options

Cryo comes from the Greek word krýos, which means “icy” or “frost”. In assisted reproductive technologies (ARTs), cryopreservation is the freezing of sperm, eggs or embryos for later use. Fertility preservation is a safe and effective way for individuals to preserve their ability to have a child after cancer treatments. It is important to note that cryopreservation should happen before starting any cancer treatments.

Sperm cryopreservation has been used since the mid 1900s. In male patients, sperm cryopreservation is noninvasive. It is currently the most effective option for men hoping to preserve their fertility. Men who have cryopreserved sperm have high chances of fathering a child, especially when those sperm are used in intracytoplasmic sperm injection (ICSI).

ICSI, a specialized form of in vitro fertilization (IVF), involves injecting a sperm directly into an egg, followed by the transfer of the embryo. Other fertility treatments such as intrauterine insemination (IUI), putting sperm directly in the uterus, may be possible if the patient’s thawed sperm has high motility.

Embryo cryopreservation is the process of freezing embryos created using IVF and storing them for later use. Embryos that are cryopreserved can be stored for many years. It’s important to note that sperm from a willing partner or donor is required for the production of embryos.

The steps of embryo cryopreservation include:

  • Before any cancer treatment, an egg is retrieved and fertilized with sperm to produce an
  • The embryo is treated with cryoprotectants and then stored.
  • When the woman has completed cancer treatment and is ready to carry a baby, the
    embryo is thawed and used to create a pregnancy.

Egg freezing is the most recent advancement in cryopreservation, and it offers many benefits. It may appeal to female patients who do not have a partner, do not wish to use donor sperm or disagree with embryo cryopreservation for ethical or religious reasons. Eggs are very susceptible to cryopreservation’s physical and chemical damage, but as research improves, it is becoming a more viable option.

It has been shown that 70% of thawed embryos created from fresh eggs survive and have a pregnancy rate of 60%.

In Ontario, OHIP covers the freezing of eggs and sperm for a medical reason, such as cancer treatment. Eligibility for cryopreservation coverage requires the individual to be an Ontario resident with a valid health card. However, OHIP does not cover the cost of storing the cryopreserved specimens or the cost of any fertility drugs that may be required.

Cancer patients have more options to preserve their fertility than ever before. Life after cancer can be rich and fulfilling and can include building a family of your own. The preservation of eggs, sperm and embryos are all possible with cryopreservation, but these options must be discussed with healthcare professionals before starting any cancer treatment.