Every year, nearly 75,000 children, adolescents and young adults are diagnosed with cancer in the United States. More than ever, young cancer survivors can look forward to the future. Reproductive health issues — including the ability to have healthy pregnancies and children, prevent unintended pregnancies, and manage menopause or testicular failure — are all important to young cancer survivors.
At UC San Diego Health, we believe reproductive health care is important for every young cancer patient at every stage of the cancer journey.
We help young survivors meet their reproductive health needs with:
- Timely and comprehensive counseling before your cancer treatment. We help you safely navigate through fertility preservation treatments
- Reproductive health care to address fertility, contraception, sexual health, and menopause or testicular issues
- Resources for patients and health care providers who seek up-to-date fertility preservation information
- Opportunities to participate in clinical research to improve reproductive health in cancer survivorship
Patients facing cancer therapy have effective options to preserve their fertility. In most cases, decisions about fertility preservation are best made before treatment begins. We understand the urgency of these decisions and are available to see patients on short notice.
Services for Females
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Meet with a reproductive specialist to talk about your individual infertility risks, learn about fertility preservation options, learn about safe methods to prevent pregnancy, and make a decision on whether to undergo fertility preservation and/or birth control procedures.
This is an option for girls and young women who have started puberty. Over about two weeks, a patient goes through ovarian stimulation, which ends in a minimally invasive surgery to remove oocytes (egg cells). These unfertilized eggs may be frozen (oocyte banking) or fertilized and frozen (embryo banking) for the future. Cancer treatment can begin the day after the oocytes are retrieved.
For families with hereditary cancer gene mutations, pre-implantation genetic testing for single gene defects can be performed on an embryo before it is transferred to the woman. This greatly reduces the risk of transmission to the baby. PGT can only be performed on embryos.
For patients who will receive radiation of the abdomen or pelvis, it may be possible to move the ovaries surgically out of the field of radiation (ovarian transposition). Some other procedures may help patients with early stage gynecologic cancer save their reproductive organs during cancer surgery.
For patients with breast cancer and sometimes other types of cancer, a class of medications called GnRH agonists can be given during chemotherapy to suppress ovarian function. In breast cancer survivors, this can increase the possibility of giving birth after cancer treatment.
One ovary or part of one ovary is removed through a minor surgical procedure called laparoscopy and the outer surface (cortex) is frozen in strips for later use. This may be the best option for females who must start their treatments immediately, or for those who have not yet reached puberty.
To prevent damage during radiation therapy, a protective cover is placed over the body to shield parts of the reproductive system such as the ovaries and uterus.
Services for Males
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Meet with a reproductive specialist to talk about your individual infertility risks, learn about fertility preservation options, and make a decision on whether to undergo fertility preservation procedures.
Sperm is generally collected via masturbation but may be collected through surgery. The sperm is stored and may be used for intrauterine inseminations or in vitro fertilization in the future.
In this experimental procedure, testicular tissue is removed through minor surgery and frozen for later use. Although this option is experimental, it may be the best option for males after puberty.
Reproductive Health after Cancer Treatment
After completing cancer treatment, young cancer survivors may have questions about their reproductive health, such as:
- Is it safe to become pregnant after cancer?
- What type of birth control is best for my situation?
- Will my kids be healthy?
- What do I do about hot flashes?
- What do I do if I have premature ovarian insufficiency or testicular failure?
- How can I improve my sexual health?
Because reproductive risks vary by person, we recommend periodic follow-up with reproductive specialists to discuss these questions and to manage your reproductive health.
Insurance coverage for fertility preservation before fertility-threatening treatments is improving throughout the U.S., including recent legislation in California. Our team has expertise to help you understand your insurance coverage for reproductive health care.
Alliance for Fertility Preservation is a non-profit organization that provides information and resources focused on fertility preservation in cancer survivors.
Save My Fertility is an online fertility preservation toolkit for adults, parents of children with cancer, and providers.