Dear OncoLink "Ask The Experts,"
I am 32 and just diagnosed with rectal cancer. I am going to need surgery, radiation, and chemo. My husband and I have only been married for 3 months and don’t have any kids. What are the options for me to possibly preserve my ovaries? My doctor says the chemo (5FU) probably will not ruin my fertility, but the radiation may hurt my ovaries. Where can I get help/info?
Clarisa Gracia, MD, Oncofertility specialist at the University of Pennsylvania Health System, responds:
The options to preserve your fertility include banking embryos, eggs or ovarian tissue. If you are married, the best option for you would be to freeze embryos. This technology is well established and has an excellent chance of success. You would need to see a reproductive endocrinologist (IVF clinic) to discuss this process.
Briefly it involves ovarian stimulation with injectable medications, a minor surgical procedure to harvest the eggs, and your husband's sperm will be used to fertilize the eggs. Unfertilized eggs may be frozen for future use, but this is still considered less successful and experimental. If you are not a candidate for embryo or egg banking, ovarian tissue can be removed surgically (either a biopsy or an entire ovary) and frozen as part of an experimental protocol. Later, this tissue may be transplanted back into your body. There have been approximately 13 pregnancies conceived from this technology to date. You can find a medical center that offers ovarian tissue freezing by going to www.oncofertility.northwestern.edu and clicking on the "fertline". If you need to have pelvic radiation, you may also benefit from moving the ovaries away from the radiation field.
This question and answer was part of the OncoLink Brown Bag Chat Series, Issues Facing Young Adults After Cancer. View the entire transcript.
Sep 21, 2014 - In younger women with stage IA and IC epithelial ovarian cancer, ovarian-conserving and uterine-conserving surgery may be a safe and feasible strategy, according to a study published online Aug. 10 in Cancer.