Fertility-preserving options for women
Protection of the ovaries from radiation therapy. For women receiving radiation therapy to the pelvic region, it can be difficult to shield one or both ovaries. If both ovaries receive radiation treatment, infertility may be permanent. However, in many cases, both ovaries do not receive radiation treatment, so any resulting infertility may not be permanent. Another option is oophoropexy, which involves surgically moving one or both ovaries out of the radiation field.
Embryo cryopreservation. This is the process of harvesting eggs for in vitro fertilization and freezing the embryos for later use in women of reproductive age. Some ethical issues—such as what to do with unused fertilized embryos—arise with this technique and require careful discussion.
Oocyte (unfertilized egg) cryopreservation. Freezing unfertilized eggs is currently investigational.
Ovarian-tissue preservation. This method is currently investigational; it requires the surgical removal, preservation, and reimplantation of ovarian tissue both before and after puberty. This may not be a practical option for girls younger than age 18 because of informed consent issues.
Gonadotropin-releasing hormones (GnRH) analog treatment. In this investigational approach, GnRHs are given along with chemotherapy to potentially reduce the possible harmful effects of chemotherapy on the reproductive organs and to lower the risk of infertility after treatment.
Abdominal radical trachelectomy. Recent research shows that women with cervical cancer who have surgery to remove the cervix while keeping the uterus intact may become pregnant. In such cases, the baby would be delivered by cesarean section.
Oral contraception. Some research shows that women who take oral contraceptives (birth control pills) during chemotherapy may conserve eggs following treatment. This approach is still investigational and may not be recommended for a woman with a tumor that is sensitive to hormones (such as some types of breast cancer).
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