NCCN Guidelines for Patients® | Caring for Adolescents and Young Adults - page 36

36
NCCN Guidelines for Patients
®
: Caring for Adolescents and Young Adults
Version 2013
Part 3: Preparing for the future
After treatment
Even if you’ve already started or completed cancer
treatment, you still have the opportunity to have a family.
Sometimes the body recovers naturally from treatment-
related damage. If it doesn’t, you can consider the
following options:
Donor eggs or donor embryos
– Donor eggs are
harvested from women who have volunteered to
go through hormone treatment to produce multiple
eggs, whereas donor embryos are donated by
couples who have chosen not to use their frozen
embryos. Donor eggs are fertilized through IVF
using a partner’s—or donor’s—sperm. The cost can
range from $5,000 to $15,000 (in addition to the
cost of IVF), and there is a risk of having more than
one baby since more than one embryo must be
implanted.
Adoption
– This is an option for anyone who wants
to become a parent. Some adoption agencies may
require that you be cancer-free and off treatment for
5 years before adopting a child. And the adoption
process itself can take up to 2 years. Costs can
range from a few thousand dollars—when adopting
through a public agency or foster care program—to
as much as $40,000 for an international adoption.
Surrogacy
– If treatment-related damage to
the reproductive organs makes it impossible to
carry a child, couples who have frozen embryos
may consider using a surrogate—a woman who
volunteers to have the embryos inserted into
her uterus and go through pregnancy and birth.
Sometimes the surrogate is a relative or friend.
Surrogacy can be expensive (anywhere from
$10,000 to $100,000) and legally complicated,
as the laws governing surrogacy vary from state
to state. It can also result in more than one baby,
since more than one embryo is usually implanted.
Questions to ask your doctor about:
Fertility preservation
What are my fertility preservation options?
Will any of the fertility-preservation options
affect how well the cancer treatment works?
Will using one of these options require that I
delay cancer treatment? If so, for how long?
What are the risks of delaying therapy?
Will fertility treatments increase the risk that
the cancer may return?
For women: Will becoming pregnant
increase the risk that the cancer may return?
Am I eligible for a clinical trial for fertility
preservation?
How much will these fertility-preservation
options cost?
Are any of these fertility-preservation options
covered by insurance?
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