Cancer and fertility

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Chemotherapeutic treatments and radiotherapy can affect male and female fertility causing both temporary and permanent infertility.

Below you have an index with all the points that we will discuss in this article.

Index

Cancer and fertility

The effect is different depending on the treatment received and other factors such as the type of cancer, where it is located, age, general health and response to treatment.

Effects of oncological treatment on fertility

Chemotherapy removes cells in the body that divide rapidly. Since sperm have a rapid division, they are an easy target for the damage caused by chemotherapy.

Radiation therapy treatment for cancer

Radiation treatments use high-energy rays to kill cancer cells and high doses of radiation kill the sperm-producing stem cells.

Permanent infertility can arise if all the spermatogonial stem cells (the immature cells in the testicles that divide to produce new sperm) are damaged to the point of not being able to produce mature sperm.

In women, chemotherapy can damage the ovules, the ovarian follicles (sacs in the ovaries that contain the ovules) and alter sex hormones. Radiation can also affect them if the treatment covers the entire body or is concentrated near the reproductive organs or the pituitary gland (pituitary gland). In addition, cancer treatment can also affect the ability to carry the pregnancy to term.

For all this, it is important to consult a specialist before receiving treatment, as there are ways to preserve or protect fertility before and even during it. However, after the options are often more limited, infertility can be irreversible.

Preservation of fertility

In the case of men, there are two options:

  • The freezing of semen: it is better to perform it before starting the treatment, since once it is started there is a greater risk of producing genetic damage to sperm.
  • Cryopreservation of testicular tissue: it is still a research method that consists in the extraction, freezing and storage of testicular tissue that can then be repositioned after oncological treatment.
Cryopreservation of male gametes

In the case of women, the alternatives are the following:

  • The vitrification of ovules: consists in obtaining and storing the frozen ovules for later use in an assisted reproduction treatment.
  • The cryopreservation of embryos: in this case the ovules are fertilized to produce embryos that can be transferred to the uterus after the end of treatment.
  • Ovariopexy or ovarian transposition: the ovaries are surgically moved to another part of the body, away from the area receiving radiotherapy to avoid damage.
  • Preservation of ovarian tissue: This is an experimental process in which a portion of ovarian tissue is frozen to place it back in the body after cancer treatment.
  • The in vitro maturation of oocytes: consists in the collection of immature ovary ovary and its subsequent maturation in the laboratory so that they can be used later in an in vitro fertilization treatment.
  • Ovarian suppression: is an experimental method that involves the use of certain hormones to stop the ovaries from functioning. Current research suggests that this is not a good option to protect fertility during cancer treatment, but clinical trials continue.

In the case of children with cancer who have not gone through puberty, the possibilities of preservation are still being studied and include testicular cryopreservation for men and cryopreservation of ovarian tissue for women, since they are not yet able to produce gametes and therefore the cryopreservation of ovules and spermatozoa is impossible.


freezing of ovarian tissue in Valencia(Spain)

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