In 2022, it is estimated that more than 8,200 Australians under the age of 40 – in their reproductive years – will be diagnosed with cancer. This is more than double the rate in the 1980s.
The good news is that more men, women and children are survivors of cancer than ever before. This is due to earlier diagnosis being more successful. cancer treatment,
Now more than 85 percent of patients under the age of 40 will still be alive five years after their cancer diagnosis.
However, many of them may not be aware of the potential reduction in fertility after cancer treatment and their options to protect their future ability to have children.
Some estimates suggest that only half of people with cancer have a documented fertility preservation discussion.
How cancer treatment can affect fertility
cancer and its remedy May reduce fertility for all sexes. Chemotherapy, radiation, and surgery can permanently reduce the number of egg and sperm cells, which can make it difficult to conceive in the future.
Egg reserves are kept before birth, and to date there is no good evidence that eggs can be replenished.
Chemotherapy — chemical drug treatments that attack cancer cells — can also damage delicate egg and sperm cells and reduce their numbers.
Similarly, radiotherapy — radiation energy directed at cancer cells — can scatter and cause scarring of the ovary and testicular tissue.
Sometimes, with high-dose chemotherapy or radiotherapy, all eggs, sperm cells, and supporting tissue may be destroyed. Direct surgery to the reproductive organs can reduce fertility.
It is often not known what the full effect of cancer treatment will be. fertilityAnd the effect can be different for each person.
What is oncofertility, and how can it help?
Oncofertility is a relatively recently established medical field that offers fertility preservation options.
Addressing quality of life from biological, psychological and social perspectives acknowledges the potential crisis cancer survivors face from reduced fertility.
Advances in assisted reproductive technology, such as vitrification (rapid freezing), mean that we can preserve eggs, embryos, ovarian tissue, sperm and testicular tissue for future use.
This is known as medical fertility preservation.
Preservation of fertility may be the best chance anyone can have for biological children in the future. Oncofertility considers a person’s future goals for cancer treatment as well as family and parenthood.
4 new things we know about oncofertility
This year, the Clinical Oncology Society of Australia (COSA) updated its guidelines for fertility preservation for people with cancer.
It is based on advice from Australian experts, including medical experts, scientific researchers, psychologists, health managers and nurses, public consultation and feedback.
COSA guidelines discuss fertility treatment options, referral routes, and psychological support. They also cover contraception during cancer treatment (to avoid disruption of treatment regimen), interrupting hormone treatment to conceive, aiding in fertility, and the risk of cancer recurrence.
This guideline is intended to support conception and pregnancy in cancer survivors.
In our paper published today in the Medical Journal of Australia, we update medical practitioners on the latest oncofertility knowledge: that pregnancy rates following egg-freezing are similar to those after embryo-freezing, with live birth rates of 46 percent respectively. and 54 percent. a study ovarian Tissue freezing and grafting is no longer considered “experimental” for women, although special inspection is recommended for pre-pubertal girls under the age of 13.
This is because the clinical experience of patients who are 20 years of age or younger at the time of fertility preservation, limited to extracting sperm from testicular tissue by microsurgery, may be considered for men who are already undergoing treatment for cancer. Testicular tissue freezing in pre-pubertal boys is currently considered “experimental” because there are no mature sperm cells. Clinical oversight is needed while new methods for using these early cells for reproduction are tested.
timing is important
Once cancer is diagnosed, discussions and decisions about fertility can be immediate and time-critical.
This is to allow time for referral to an oncofertility unit, appropriate counseling and informed decision making.
Planning and performing fertility preservation takes time (for example, it can take about 14 days for eggs to grow and freeze to be collected) so readiness is important to prevent delays in cancer treatment.
Not all people of child-bearing age who have been diagnosed with cancer are immediately referred to oncofertility health services, if at all. This can lead to feelings of conflict and regret.
Our team of fertility experts from the Royal Women’s and Royal Children’s Hospitals collaborated with the Western and Central Melbourne Integrated Cancer Service to develop a suite of animated patient education videos to address this gap.
The Fertility After Cancer Video – Available in multiple languages, reviewed Cancer Patient and support groups, age-appropriate for children, teens, adults and their families – discuss fertility preservation options, risks, benefits and options.
Our goal is to provide all Australians with cancer access to information and support about the impact of cancer treatment on their future fertility.
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