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Summary

To protect against infertility caused by chemotherapy, radiation treatment or surgery, it is possible to bank  eggs, sperm and fertilized eggs (embryos) for later use. Banking eggs is still considered to experimental even though the process has been shown to work.

In general, the guideline is not to get pregnant until at least 2.5 years post.treatment. Talk to your medical team if you want to get started earlier.

For an idea about the risk to fertility involved with your type of cancer and/or treatment, click here offsite link

To find the appropriate fertility doctors and resources in your area, search on FertileHope offsite link and/or FertilityScout offsite link

Finances

If you have health insurance, it is worth checking to find out if your policy will cover preservation. If your policy does cover fertility, it likely covers preservation. However, most policies require evidence of infertility - which is not usually the case when a person wants to use fertility preservation techniques due to an upcoming treatment.

Financial assistance may be available. Call Live Strong: 855.220.7777. Live Strong also offers a fertility discount program. Go to livestrong.org/we-can-help/fertility-services offsite link/

Other means of obtaining a child are:

  • Using another person's eggs 
  • Having a surrogate woman carry your child 
  • Adoption

For information about using another person's eggs or having a surrogate carry your child, speak with your primary care doctor or gynecologist.  For information about adoption, click here.

Genetic Concerns

It is natural to be concerned about the genetic risk of passing cancer to your children. If this is a concern to you, testing may be able to determine whether or not an embryo carries the genetic profile for certain cancers. Keep in mind that this testing can only be done when becoming pregnant through the in vitro fertilization process. Eggs are fertilized, and then screened for the disorders prior to implantation.

NOTE: Imerman Angels pairs cancer patients, survivors and caregivers with mentors, including young cancer survivors who have had experience with and concerns about infertility. See: imermanangels.org offsite link

Additional information

Banking Eggs

It is now possible for women to protect the ability to have a child. The most common method is to freeze eggs to become pregnant at a later time.

If there will be pelvic radiation: an alternative is to undergo a procedure known as an Ovarian Transposition. An Ovarian Transposition is a surgical procedure where one or both ovaries are moved out of the pelvis, so that they are out of the field of pelvic radiation. They are eventually reinserted. For more information, click here offsite link.

The remainder of this document focuses on freezing eggs.

Freezing Eggs

Egg freezing is still classified as experimental. National data on results is limited. However, an experienced clinic can provide data about their own experience. 

Before proceeding, it is advisable to seek an expert in freezing eggs. At least ask about:

  • How long the clinic has been in existence.
  • The education and experience background of the principals.
  • The clinic's pregnancy rates.
  • The number of eggs needed to provide a reasonable chance of ultimately having a baby.
  • The chances of a miscarriage (the miscarriage rate).

How The Egg Freezing Process Works

In general:

  • Eggs are extracted from the ovaries.
  • Eggs are then cooled with liquid nitrogen to 196 degrees Centigrade. The theory behind this temperature is that there is no metabolism or cellular activity so eggs can be preserved indefinitely.
  • The eggs are thawed when pregnancy is desired. The eggs are then fertilized and returned to the uterus by means of standard in vitro fertilization (IVF).

Alternatively,

  • An egg can be fertilized now and the resulting embryo is frozen:
  • Tissue can be removed from the ovaries and frozen to be used in place of an egg.

Cost Of Freezing Eggs/Insurance

$10,000 to $20,000. It is not likely that this cost will be covered by health insurance - but it is worth checking your policy "just in case".

Banking Sperm

Males can bank sperm before undergoing treatment.

How the process works:

  • Sperm is harvested.
    • Generally a sperm harvest is done at a fertility center with the male ejaculating into a receptacle. If this is not possible, usable sperm can be extracted from the male's testicles though a procedure known as "Testicular Tissue Extraction".
  • The sperm is frozen.
  • When a pregnancy is desired, the sperm is thawed. The unthawed sperm is then used to fertilize an egg. The standard means of placing the fertilized egg into the uterus is by means of a process known as "in vitro fertilization (IVF)".

If a reputable fertility center is not available locally, a mail-in kit is available known as Live:On. The Live:On kit is a collaboration between the nonprofit Fertile Hope, Cryogenic Laboratories, Inc, and the Lance Armstrong Foundation. In 2011, the kit costs $675, which includes processing, analysis, freezing and storage for one year. To learn more, see: www.liveonkit.com offsite link or call 800. 466.2796.

Fertile Hope's Sharing Hope Program For Men works with companies and clinics to reduce the cost of sperm banking for eligible male cancer patients. To learn more, see: www.fertilehope.org/financial-assistance/sperm-banking.cfm offsite link

If you can't ejaculate, or if there is no sperm in your semen, an experimental option is to surgically remove and freeze testicular tissue.

Banking Embryos

Embryo freezing is one way to preserve the ability to have children.

The process, which takes place over 2 -6 weeks, is as follows:

  • Ovaries are stimulated to provide multiple eggs.
  • Doctors remove the eggs.
  • The eggs are fertilized in the lab with sperm from a partner or donor.
  • The resulting embryos are frozen for future use.

The nonprofit organization, Fertile Hope, has a Sharing Hope Program For Women that provides discounted services and donated medications for eligible female cancer patients. The financial requirement is an annual household income less than $75,000 (single) or $100,000 (married). To learn more, see: www.fertilehope.org/financial-assistance/egg-and-embryo-freezing.cfm offsite link or call: Fertile Hope: 888.994.HOPE