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28

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

.

Before treatment

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.

Damage prevention

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

ovarian transposition.

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.

o

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

several weeks.

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.

††

Egg freezing

– 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.

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 think

about the following options:

††

Donor eggs or donor embryos –

Donor

eggs are harvested from women who have

volunteered to go through hormone treatment

3

Preparing for the future

What are my options?