Fertility Preservation: What to Know
- The ability to preserve fertility depends on the stage and type of ovarian cancer
- A reproductive endocrinologist may be able to recommend fertility preserving techniques
- Freezing eggs or embryos can enable some women to get pregnant after they finish treatment
- Women who have cancer in only one ovary may be able to keep the other ovary
The earlier you are diagnosed and the earlier the stage of your ovarian cancer, the greater the likelihood that you can pursue fertility preserving options with your doctor. But it’s important to have the discussion before you start treatment.
Read MoreHow Ovarian Cancer Affects Fertility
For women with ovarian cancer, debulking surgery is typically the first step in treatment, with the aim of removing all visible evidence of the disease. This can include removal of the uterus, cervix, fallopian tubes, and the ovaries. Because the ovaries hold the eggs, having these organs removed means that you won't be able to have a typical pregnancy. Removing the uterus will make you unable to carry a child. Chemotherapy is also a concern that can impact future fertility. The drugs that are often used for ovarian cancer treatmentcarboplatin and cisplatinhave been linked with reduced fertility. Chemo can also alter levels of hormones needed to conceive and carry a pregnancy. This can result in either a temporary or permanent loss of fertility.But there may be hope. You don’t necessarily have to give up on having a family, if that’s your plan. Discuss your fertility concerns with your doctor before you have surgery or chemotherapy. Several different fertility preserving techniques have been shown to work for some women undergoing ovarian cancer treatment.
Fertility-Sparing Surgery
"Patients with stage I ovarian cancer, where it’s just confined to the ovary, are candidates for what’s called a fertility-sparing staging," says Dr. Ulm. "That's where we try to leave the other ovary and [fallopian] tube…Our goal is normally to debulk the disease and stage the ovarian cancer in a way that spares the remaining tube and ovary, as well as the uterus and cervix."
Fertility-sparing surgery preserves the uterus and one ovary and is followed up with chemotherapy, allowing women to still be able to conceive and carry a child. It may be a good option for some women with early-stage cancer.
The procedure has “generally good outcomes," says Dr. Ulm. "And after they’re done having children, then we go back and take out the other tube and ovary, as well as their uterus and cervix."
Freezing Your Eggs
Another option is to freeze your eggs or embryos before surgery through a method called cryopreservation. This involves collecting eggs. Then, either the eggs themselves are frozen, or they’re fertilized through in vitro fertilization (IVF) and then the resulting embryo is frozen. After treatment is complete, the egg can be thawed and fertilized, or the embryo can be thawed and implanted into your uterus.
Having ovarian cancer does not necessarily mean you have to give up on your dreams of having children. There are options to preserve your fertility, depending on what stage of cancer you have. Talk through these options with your doctor when you discuss your ovarian cancer treatment. The earlier you have the conversation, the more time you’ll have to consider which technique is best in your situation.
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