NCCN Guidelines for Patients
Adolescents and Young Adults with Cancer, Version 1.2017
What are my options?
Your fertility preservation options will vary depending
on your age, gender, and type of cancer you have.
Most techniques that can increase your chances of
having children must be done before treatment starts.
See Chart 2
Fertility preservation methods that can be done before
treatment fall into two basic groups: techniques that
prevent damage from happening in the first place,
and techniques that remove healthy cells (sperm,
eggs, or embryos) and store them for later use.
It’s sometimes possible to protect reproductive
organs through fertility-sparing surgery. The surgeon
removes only the cancerous tissue and leaves
as much healthy tissue in place as possible. For
example, the surgeon could leave the healthy ovary in
place if you have early-stage ovarian cancer.
Exploring your choices
If you’ll be receiving radiation therapy, you can use a
special lead shield to prevent radiation from reaching
the ovaries or testicles. If you’re a woman, it may also
be possible to surgically move the healthy ovary (or
ovaries) out of the radiation field, a process called
There is also an experimental technique called
ovarian suppression that uses a hormone-blocking
drug to stop the ovaries from producing eggs.
Although ovarian suppression is sometimes used in
the treatment of breast cancer, there's no research on
how well it works for protecting fertility.
Banking healthy cells
The most well-established methods of fertility
preservation are sperm banking for men and embryo
freezing for women.
Sperm banking is a fairly simple procedure
that involves collecting and then freezing one
or more samples of ejaculate. Men can find
a local sperm bank or go online to look for a
sperm banking kit.
Embryo freezing is more complicated because
it requires IVF, a process in which eggs are
removed from the ovaries and fertilized in a
lab. If you don’t have a partner, IVF can be
done with a sperm donor.
Since IVF must be timed to your
menstrual cycle and involves a series
of hormone shots to prompt the
ovaries to produce more than one egg,
it could mean delaying treatment for
Experimental options include:
Ovarian tissue freezing
– Surgical removal
and freezing of a healthy ovary (or part of
an ovary). When treatment is complete, the
tissue is put back.
– Use of hormones to make the
ovaries produce multiple eggs, which are then
taken out and frozen.
Testicular sperm extraction
– Removing a
small portion of tissue from the testicle while
under local anesthesia (a controlled loss of
feeling in a small area of the body from drugs)
to take out and freeze sperm cells.
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 think
about the following options:
Donor eggs or donor embryos –
eggs are harvested from women who have
volunteered to go through hormone treatment
Preparing for the future
What are my options?