Source: CBS News – July 27, 2015
A study in the journal Cancer revealed that, although 70% of patients learned cancer treatments like chemotherapy could cause infertility, only 31% of men and 6.8% of women surveyed used fertility-preserving options.
Researchers polled 459 teen and young adult cancer patients from seven different registries across the U.S. about fertility preservation counseling and strategies they had received prior to treatment. They found men were more than twice as likely to not take fertility-preserving measures if they did not have a medical oncologist, and were nearly three times as likely to not preserve their fertility if they did not have insurance. Women surveyed were over five times as likely not to preserve their fertility if they did not have insurance, and the researchers noted too few women in the study had made fertility-preserving arrangements to make other, similar comparisons with the men they surveyed.
Oncologists and fertility specialists face significant challenges in counseling adolescent and young adult patients with cancer who may not be considering family planning at a younger age.
Oncologists and fertility specialists face significant challenges in counseling adolescent and young adult patients with cancer who may not be considering family planning at a younger age. Other barriers to fertility preservation include cost of fertility preservation procedures, lack of insurance coverage, and potential delay to treatment. Oncologists may also not be aware of the latest fertility-preserving techniques. Oncologists and fertility specialists should work together to increase awareness of fertility-preserving options for all patients with a cancer diagnosis interested in current or future family building.
From Our Expert, Dr. Ronald Feinberg
“Fertility-preserving options are available for young men and women with a cancer diagnosis, but the key is to act quickly.”
Usually, the last thing on a teenager’s mind is fertility preservation. Some adolescents and young adults may think about the fact they wanted to be parents, but overall that’s not usually their first concern. Oncologists, reproductive endocrinologists, and parents need to have that initial conversation. It might be overwhelming at the time, but it’s very important to talk about fertility preservation beforehand so that these young men and women know their options. In this situation, preserving one’s fertility is one thing patients can have some control over, and that’s very powerful when faced with a cancer diagnosis.
The younger someone is prior to chemotherapy, the more likely it is that ovaries and sperm will recover. A person’s options will depend on the diagnosis, how sick they are, how much time they have before beginning cancer treatment, and the type of cancer treatment. Depending on the treatment—the kind of chemotherapy or radiation they’re getting—it could render them incapable of having a family. That is something that has been shown to cause significant regret and depression later in life.
When patients with a cancer diagnosis come to us with fertility preservation needs, we need to act quickly and be able to accommodate them. We are typically available within 24 to 48 hours of a patient reaching out to us or after a referral from an oncologist—in many cases, we will be able to see patients even sooner than that. During a consult, I review all of the available options, and if they’re interested, I will call their oncologist directly to talk about the treatment planned, how much time we have for fertility preservation options, and whether they think it’s safe for the patient.
In terms of treatment options for post-pubertal men, RADfertility offers sperm freezing, and we also work with urologists to coordinate testicular biopsies and freezing. Unfortunately, we do not have the ability to do pre-pubertal testicular biopsy and freezing; this is an experimental procedure and should be done at one of the few academic centers with a research protocol for that technology.
For young women, we offer egg freezing as the primary fertility preservation option. If they have a partner, embryo freezing may also be an option. RADfertility will offer ovarian tissue freezing once we receive IRB approval to use the technology. Until then, we have colleagues at other centers who are able to perform ovarian tissue freezing immediately.
Patients who have already undergone cancer treatment may still have ovarian or testicular function and may be able to conceive on their own. If they are not able to conceive on their own, the options available to them are donor egg, donor sperm, or donor embryo.
At our office, we have the ability to get started the same day as a consult, or the following day thanks to our excellent IVF coordinators, nursing staff, and support staff who are able to effectively accommodate these patients. We coordinate with a patient’s schedule and want to know that they feel comfortable moving forward. RADfertility is part of the Oncofertility Consortium, a group of oncologists and reproductive endocrinologists that offer fertility preservation to patients across the country. Patients can visit the website for information and no matter where they are in the country, they can find the center that’s closest to them.
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"I feel so lucky to have found RADfertility. I tried two other clinics before I expanded my search and found RADfertility. I drive an hour each way to go to them but I don’t regret a thing. They are so caring and so professional. Every time I message them they respond quickly. Every time I see them they have a friendly smile and warm welcome. They explain everything so well and I never feel lost in the process as I did elsewhere. They also took the time to figure out what was wrong. Other clinics threw up their hands, said 'I don’t know' and pushed me to try IVF."
"Dr. Feinberg and the entire staff at RADfertility are absolutely amazing. The receptionists, coordinators, nurses, and lab staff are compassionate, caring, and straight forward. I’ve had a 12-year infertility journey and I’ve tried other clinics but RADfertility was the only one I felt at ease with. They answered any questions that I had and were there any time I needed them. My coordinator, Amy, was the absolute best and always had my back. Dr. Feinberg’s dedication to his patients is incredible. You are not just a number there, you are a person with individualized needs and care."
"My journey with RADfertility and Dr. McGuirk started when my husband and I were trying to conceive and were having difficulty. We went to RADfertility, where we met Dr. McGuirk. I always say she changed my life and 'fixed' me. Dr. McGuirk is always learning more about endometriosis and how to help her patients. She’s brilliant and truly cares for you! I’m eternally grateful to her and everyone at RADfertility for their unwavering support, love, and care."
"Every step of our journey was tailored to us. We were treated so respectfully. Every detail was clearly explained and we felt so comfortable. Rhonda Wright was a Godsend and inspiring. I highly recommend this place! I cried when my weekly appointments were done and I 'graduated.'"
"The day I met Dr. Neithardt I knew she was the perfect doctor for me. Dr. Neithardt was so compassionate every step of the way. She held my hand, she hugged away tears, and continued to give me hope. There are not enough 'thank you's' in the world for Dr. Neithardt and the whole RADfertility team who will forever have a special place in my heart."
"RADfertility's staff has heart and provided me with exceptional health care. I knew I was in good hands and felt like we were in this together. The doctors and nursing staff always answered all of my questions and provided thorough information about all of my options. I am so fortunate and appreciative of the care that I received at RADfertility. They go above and beyond."
"I cannot begin to explain how wonderful RADfertility is. We were frustrated with trying to start a family and it not working for us. The entire team of doctors and nurses made us feel comfortable and hopeful that we would be parents. We experienced so many ups and downs but we never felt like we were on our IVF journey alone, we had our RADfertility team every step of the way. If you're looking for a supportive team on the IVF journey, look no further. RADfertility is the absolute best."
"Dr. Schillings always kept us informed and never gave up on us. She always explained our options and risks with each procedure. She called us personally when there were any issues or sensitive subjects to cover. Dr. Schillings was the first doctor that had answers for us and wanted to help us have our miracle baby!"
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