Radical Trachelectomy
This surgical procedure is used in the treatment of early stage cervical cancer, as an alternative to the more standard hysterectomy (removal of the uterus). Trachelectomy removes the cervix—the neck of the uterus—but leaves the uterus itself intact. Women who have this procedure have a more than 50 percent chance of becoming pregnant over five years, and there have been over 100 pregnancies resulting in live births so far to women who had trachelectomies.
Egg Donation
Cancer survivors whose uterus is still intact may be able to become pregnant using an egg donated by another woman. The egg is then fertilized in the lab (IVF) with sperm from the cancer survivor’s partner. The woman herself—or a gestational carrier—can carry the pregnancy.
Drug-induced (temporary) Menopause
The drug Cetrorelix suppresses ovarian function, and seems to protect the ovaries during chemo. Scientists at the Royal Women’s Hospital in Melbourne, Australia, conducted a small study in which the drug was used to suppress gonadotropin-releasing hormone (GnRH), which triggers ovulation. Women stopped taking the drug when chemo was finished. Of the 18 women studied, 94 percent recovered their fertility and resumed spontaneous and monthly cycles within a year. Still experimental, more studies are needed.
Despite all these available options, a 2006 study by the American Society of Clinical Oncology (ASCO) found that fertility preservation methods are still used infrequently in cancer patients. That’s why the ASCO recommends that oncologists consider fertility preservation as early as possible during cancer treatment planning, including referrals to reproductive specialists. According to that same 2006 study, sperm and embryo cryopreservation are now considered standard practice and are widely available. While recent public debate, media interest, and scientific studies have increased awareness among both patients and oncologists about the options to prevent infertility, education about fertility-preservation options still remains “a gradual process,” says Dr. Oktay. “We’re at a better point than five years ago. But there’s still a lot of discrepancy [in degree of awareness] depending on geographical area and education level of the patients.”
