Fertility preservation is a paramount concern for women facing cervical cancer. In this exploration, we navigate the challenges and viable options, shedding light on the crucial aspect of preserving reproductive possibilities amidst medical treatments. Expert insights guide the discussion, emphasizing the significance of informed decisions and advancements in fertility preservation techniques for women undergoing cervical cancer treatment.
Dr Sweta Gupta, Director IVF, Max Healthcare says, “Uterine cervical cancer is the fourth most common malignancy in women worldwide. Fertility preservation techniques allow for saving gametes from damage by surgical, radiotherapy and chemotherapy treatment. The approach includes fertility-sparing surgery options as well as oocyte and ovarian cortex cryopreservation. Options for each single patient need to be assessed by a multidisciplinary reproductive team, to select the most suitable procedure.”
“Due to technological advances made in the past decade, oocyte cryopreservation has become a viable option before gonadotoxic therapy. It may be appropriate for women whether single or partnered, for postpubertal girls, and for those who have objections to embryo cryopreservation. In cancer cases, there is limited time to induce controlled ovarian stimulation for oocyte maturation. Nowadays, advanced fertility specialists immediately start ovulation stimulation using newer random stimulation protocols. Oocyte cryopreservation should be completed before neo-adjuvant chemotherapy or combined chemoradiation,” highlights Dr Sweta.
Dr Sweta adds, “Conservative fertility-sparing treatment such as radical trachelectomy in cervical cancer, hormonal treatment of early endometrial cancer, and conservative surgical management of early-stage epithelial ovarian cancer may be possible for certain women with early invasive disease. Reducing the radiation dose to the ovary by shielding or surgically moving the ovaries from the field of radiation (i.e. oophoropexy) may preserve ovarian function.”
A diagnosis of cancer can be a life crisis for any person. Its impact varies with the type of cancer, treatment prospects, and the physical, emotional, and social resources of the patient. Younger individuals face the additional potential loss of reproductive function and the opportunity to have children.
“Surveys of cancer patients reveal a very strong desire to be informed of available options for fertility preservation and future reproduction. At the same time that patients who wish to reproduce in the future (and their parents in cases involving minors) receive a diagnosis of cancer, they also must consider possible effects on fertility,” suggests Dr Sweta.
Dr Sweta concludes, “To preserve fertility, they may need to accept changes in standard treatment protocols or undertake steps to preserve gametes or gonadal tissue that carry their risks and uncertainties.”