Women & Infants: Preserving Fertility for Life After Cancer
Tuesday, December 20, 2011
When a woman receives a cancer diagnosis, with the support of her team of oncologist, support physicians and other medical professionals, she begins a process of understanding, engagement, and attack of the medical issues,.
Here in Rhode Island, that team can also include fertility preservation services, which can integrate immediately into an overall plan to help women plan for and look forward to their lives after cancer.
"Many women are going to undergo treatments or surgeries that threaten their ability to reproduce," says Jared C. Robins, MD, at the Center for Reproduction & Infertility at Women & Infants Hospital of Rhode Island. According to Dr. Robins, both chemotherapy and radiation, while life-saving, may threaten fertility.
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From birth, a woman’s ovaries contain all of the eggs that she will ever make. In order to ovulate and be fertilized, these eggs undergo a process of maturation. Because chemotherapy targets dividing cells, the medications may attack these dividing eggs’ cells.
Reducing the number of eggs that a woman may makes it harder for her to become pregnant. It may also cause early menopause (the likelihood that this will happen depends on a variety of factors, including age, the type of chemotherapy and duration of the treatment, as well as a woman’s medical history).
Radiation and fertility
Like chemotherapy, radiation treatment destroys dividing cells. If a woman’s ovaries are in the field that her oncologist is targeting with the radiation, those eggs could be damaged by the therapy.
Strategies for women: looking to the future
"A patient who's just been diagnosed with cancer was assumed not to be thinking about her fertility," Dr. Robins says. "That's false. For a lot of women, the first thing they think about is, 'Will I be able to have children?'"
At the Center for Reproduction & Infertility, a team of highly specialized doctors, nurses, and embryologists works with a patient to immediately begin discussion of her treatments and make plans for her life after cancer.
Options may include freezing tissues - including the ovary, eggs removed from the ovary, and embryos that are created with eggs and sperm in the laboratory - to be used when treatment is over.,.
In certain cases, when radiation treatment is required, doctors may recommend certain medications to protect the ovaries, or the patient’s ovaries can be surgically moved to a different place in the abdomen to protect them from radiation. This procedure, called ovarian transposition, is done in the operating room using a video camera (laparoscopy).
Also, patients will have the opportunity to speak with a psychologist as well as a social worker to help in any and all decision-making.
Not just babies
When ovarian function is affected, hormonal implications reach beyond fertility, according to Dr. Robins. "We're going to discuss fertility preservation, but we're also going to discuss menopause and hormone replacement therapy, and sexual function and libido," Robins says. "In that sense, we wind up being the patient's cheerleaders."
Dr. Robins points out the double benefit in this combined support for women. "Patients go to their oncologist and they hear a lot about their treatment, and their oncologists are very upbeat because we know they're going to do very well," he says. "But they're hearing about the side effects of radiation, the side effects of chemotherapy, and then they come to us and we're going to talk about having babies, and having fun, and surviving.
"They leave our offices feeling very positive about what life is going to be like after cancer."
For more on Women & Infants’ Center for Reproduction & Infertility services, go here.
For more Health coverage, go to GoLocalTV, fresh every day at 4pm and on demand 24/7, here.
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