Fertility preservation is a subspecialty within the field of reproductive endocrinology and infertility, that focuses on helping reproductive-age men and women who are faced with cancer treatment understand their risks of infertility and possible treatment options. Research into how cancer affects reproductive health and preservation options are growing, sparked in large part by the increase in cancer patients’ survival rates. We understand that time is of the essence when faced with a cancer diagnosis and are committed to seeing these patients within 48 hours of when they initially contact us.
Fertility preservation, such as ovarian tissue or oocyte cryopreservation, may also be used to prevent infertility, as well as birth defects, associated with advanced maternal age. Advances in technology and medical expertise have provided us with more options than ever to help preserve our patients’ fertility.
The main methods of fertility preservation are ovarian protection by GnRH agonists, cryopreservation of ovarian tissue, eggs or sperm, or of embryos after In Vitro Fertilization (IVF). Patients may also choose to use egg or sperm from a donor by third party reproduction rather than having biological children. Learn more about the treatment options we offer.
We understand that survival is the primary consideration as patients prepare to undergo chemotherapy or radiation. However, UNC’s Fertility Preservation Program is designed to provide information tailored to each individual patient regarding his or her risks of decreased fertility potential after cancer treatment. Chemotherapy or radiation can damage sperm and eggs, but the degree of damage is often difficult to predict.
For women, one marker of decreased fertility potential after cancer treatment is the loss of menstrual cycles, or premature menopause. However, some women who still have menstrual cycles after their cancer treatments may have “diminished ovarian reserve.” This means that the ovaries were damaged by treatment, but there is some ovarian function remaining. Patients with diminished ovarian reserve may have difficulty conceiving, either on their own or with assisted reproductive therapies (ART).
For men, either the cancer itself or the cancer treatments can cause infertility. Specific cancers that can damage the testes include testicular cancer and Hodgkin’s Lymphoma. Posttreatment sperm counts can be considered either normal, low or completely absent.
Factors that may play a role in future infertility include:
- Chemotherapy medications, dose and number of cycles
- Radiation dose and location
- Prior difficulty conceiving
- Prior surgeries