Various Cancer Treatments: Omegahospitals.com

Fertility

Various cancer treatments - including surgery, chemotherapy, and radiation therapy-can cause infertility under certain circumstances. Surgery to the sex organs or areas around these organs may reduce fertility. The risk of infertility from chemotherapy depends on the type and dose of drug, as well as how it is given, while the risk of infertility from radiation therapy depends on the dose of radiation and the area of the body that is exposed to radiation.

Some treatments that can cause infertility in men:

Chemotherapy: Sperm cells divide rapidly, so they are an easy target for damage by chemotherapy. If the stem cells in the testicles are damaged and these no longer produce sperm cells, it can lead to a permanent fertility.
Radiotherapy: If the radiation aims at testicles, man fertility can be affected, as radiation at high doses kills the stem cells that produce sperm. Sometimes radiation to the brain may affect the pituitary gland, which signals the testicles to make hormones, causing infertility.
Testicles Ablation: If only one testicle is removed, the patient may continue to make sperm after surgery. If both testicles are removed, the patient will no longer be fertile. This kind of surgery may be necessary in prostate cancer.
Prostate Surgery: If the cancer has not spread too much, the treatment is a surgery that removes the prostate gland and seminal glands, which can make the patient infertile.
Other Surgeries: Removing lymph nodes in the pelvis and some operations for colon cancer, can damage nerves and this causes problems with ejaculation.

Generally, before you start treatment, you must talk to your doctor about the possible affect on your sexual function and fertility. Your doctor and/or a reproductive endocrinologist (a doctor who specializes in fertility issues) can help you learn about your options. You may also consider speaking with a counselor for guidance about these decisions.

Fertility-preserving options for men include:

Shielding the testes from radiation therapy, if the cancer is present in other parts of the pelvis.
Sperm cryopreservation (sperm banking) can be done where sperms are frozen and stored for men who wish to father children later in life. It is an option for most men who have reached sexual maturity.
Another investigational option involves the removal, freezing, and storage of testicular tissue that is surgically re-implanted after cancer treatment.
Hormonal gonadoprotection uses hormone therapy to protect testicular tissue during chemotherapy or radiation therapy, and it is still investigational.

Cancer treatments that can cause infertility in women:

Chemotherapy: Many chemotherapy drugs can damage or destroy some of the eggs stored in the ovaries. The effect will depend on the type and dose of chemotherapy treatment and the patient's age.
Radiation Treatments: The ionizing rays can also damage woman's ovaries. Even if the radiation is not aimed right at the ovaries, there is a risk for them to be damaged. Sometimes radiation to the brain may affect the pituitary gland, which signals the ovaries to make hormones responsible for ovulation, but this not always causes infertility.
Surgery: For some cancers in women, a hysterectomy (uterus ablation) or/and ovaries ablation are part of the treatment. After those surgeries, a woman cannot carry a child. Sometimes surgery can cause scars in the fallopian tubes, and this may prevent the ovules of going across the tubes to be fertilized and moving to the uterus to be implanted.

Fertility-preserving options for women:

For women receiving radiation therapy to the pelvic region, both ovaries do not receive radiation treatment, so any resulting infertility may not be permanent.
Another option is oophoropexy, which involves surgically moving one or both ovaries out of the radiation field.
Embryo cryopreservation is the process of harvesting eggs for in vitro fertilization and freezing the embryos for later use in women of reproductive age.
Oocyte (unfertilized egg) cryopreservation is a process of freezing unfertilized eggs.
Ovarian-tissue preservation is a method that requires the surgical removal, preservation, and re-implantation of ovarian tissue both before and after puberty.
Gonadotropin-releasing hormones (GnRH) analog treatment is a treatment where are given along with chemotherapy to potentially reduce the possible harmful effects of chemotherapy on the reproductive organs and to lower the risk of infertility after treatment.
Abdominal radical trachelectomy is a surgery of cervix while leaving the keeping the uterus.

It is important to talk with your doctor (or your child's doctor) as early as possible in the treatment process about how cancer treatment may affect fertility. Many interventions to preserve fertility need to take place before cancer treatment begins.