Assisted Reproductive Technologies and the Cancer Patient

The Cancer Risk Clinic can provide genetic counseling regarding reproductive options for cancer survivors and patients anticipating cancer treatment after the diagnosis of cancer. As a result of advances in the treatment of cancer during childhood, adolescence, and young adulthood, many patients are surviving to ages where they would like to have the option of having children. Unfortunately, various cancer therapies can cause the patient to experience the loss of reproductive function. We can address concerns regarding cancer treatment modalities and their impact on future fertility.

It is also possible to treat and manage cancer with the intention of fertility preservation. The traditional management of ovarian cancer, for example, identified early is complete surgical staging including total abdominal hysterectomy and bilateral salpingo-oophorectomy. If the patient meets certain criteria and desires the option of childbearing in the future, it may be appropriate to manage her cancer more conservatively. Standard treatment for invasive carcinoma of the cervix and the uterus typically includes hysterectomy and subsequent loss of reproductive potential. The possibility of treating these cancers less aggressively may be appropriate for some patients with early stage disease.

Counseling regarding currently available assisted reproductive technologies available to infertile patients including in-vitro fertilization (IVF) and gamete donation is available through the Cancer Risk Clinic. Fertility preservation options for each cancer patient should be determined after careful determination of pre-treatment ovarian function, assessment of psychosocial history, and personal risk factors based upon planned treatment strategy and previous gynecological and fertility history. Standard fertility treatment should be considered prior to experimental options.

Some patients that are found to have a hereditary susceptibility to cancer and an identified mutation is found in the family may be concerned about passing on this risk to their offspring. Counseling regarding the potential risks and benefits of undergoing IVF and Preimplantation Genetic Diagnosis (PGD) to avoid the birth of a child that will have an inherited susceptibility to cancer. PGD is a technology that is available for families that have a known genetic mutation for a hereditary susceptibility to cancer.