Cancer is a devastating disease. The cancer treatments available today are indeed life- saving but, they come at a terrible price! Girls and young women who undergo chemo and or radiotherapy are at the abominable risk of losing their fertility. Ovarian failure and infertility are the imminent after effects of cancer treatment in these patients. Loss of fertility can mar a woman’s life permanently. In such conditions, preserving fertility becomes a matter of utmost priority. Shocking as it may sound, but it is not uncommon that a woman with cancer may not be correctly informed by her doctors that she may lose her fertility after treatment.
An article in the journal OncoLog (Stephanie Deming, January 2006, vol 51) says that, “in two recent surveys of oncologists and patients at major centers, Dr. Leslie Schover, professor in the Department of Behavioral Science at The University of Texas M. D. Anderson Cancer Center, found that oncologists sometimes do a poor job of informing patients about the possibility that certain treatments might cause infertility. “Maybe they mention it quickly during informed consent and it goes right over the patient’s head, because they have so much information coming in,” Dr. Schover said. Later, once patients have recovered from cancer treatment and realize that they might have been able to preserve their fertility if only someone had informed them in time about their options, they can feel devastated.”
Around 50,000 women in the US are diagnosed with ovarian cancer every year. Breast cancer is the most common cancer found in women and is a leading cause of death in women after lung cancer. According to the American Cancer Society, breast cancer rates have increased by 30% in past 25 years in the western countries. Breast cancers are not common in young women and the incidence of cancer in women in their twenties is 1/ 1,985, and 1/229 for those in their thirties (American Breast cancer Society facts and Figures, 2005-2006). These figures are truly alarming since the rates of cancer incidence are steadily increasing over the past few years. The number of younger women with cancer is bound to rise in years to come. Given these circumstances, the issue of preserving one’s fertility despite the cancer and its treatment, is going to be of major concern.
The solution to this concern is Cryopreservation, the revolutionary method used in assisted reproductive technology. The healthy, unaffected oocytes or ovaries of a woman with cancer are removed before treatment and stored using cryopreservation so that, they can be used later after the cancer is fully treated. The technology of ‘Cryopreservation’ or preservation of body tissues by cooling at low subzero temperatures is proving to be a boon to women with cancer. To say in easy words, Cryopreservation is based on the principle that storing of body tissue at low temperatures puts the tissues in a mode of suspended biological activity and biological reactions. Hence the tissues are very much alive but their activities are stopped. When thawed they are able to perform their normal functions. Cryopreservation has recently been playing a major role in assisted reproductive technology.
Depending on the age of the women, their situation (single, married) and the type of treatment that they will undergo, their oocyte i.e. the female egg, or an embryo (fertilized ovum using the partner’s or donor’s sperm) or their ovarian tissue can be preserved by the method of Cryopreservation. This way the healthy oocytes and ovarian tissues can be saved from the harmful effects of the chemo and or radiotherapy. Once the patient has fully recovered from the cancer treatment, the preserved tissue can be transplanted back into the woman’s body. If it is a cryopreserved embryo, it can be implanted into the mother’s womb.
Although the outcomes of In-vitro fertilizations where fresh embryo, fresh oocytes are used is around seven times higher (OR- Odds ratio) than the cases where their frozen/ cryopreserved counterparts are used (Fertility Sterility-2006). But, this option of using fresh oocytes or embryo is not open to women with cancer. Cryopreservation till date remains the best option available for women diagnosed with cancer, and I feel it is worth the efforts.