What is Oncofertility? Understanding Fertility Preservation for Cancer Patients

A cancer diagnosis is more than a medical event, it can immensely shake a life as you know it. It shifts your plans, your peace of mind, and for many, it shakes your sense of what your future might look like. If you're hoping to have children someday, one of the most pressing (and often overlooked) questions is, "Will I still be able to have a family after treatment?" The unfortunate truth is that cancer therapies, while life-saving, can also threaten reproductive health. That’s where oncofertility steps in.

What is Oncofertility?

Oncofertility is like a fusion of two complex fields. It merges oncology, the study and treatment of cancer, with reproductive medicine. In plain language, oncofertility is a medical specialty dedicated to preserving fertility in patients who are about to undergo cancer treatments. Cancer treatments, which often include chemotherapy, radiation, or surgery, can damage the ovaries or testicles, disrupt hormone production, or destroy sperm and eggs entirely.

Rather than treating fertility as an afterthought, oncofertility brings it to the forefront. It gives cancer patients options. It opens the door to biological parenthood even after some of the most aggressive cancer therapies. It’s about protecting your ability to choose parenthood whenever you’re ready.

How Cancer Treatments Affect Reproductive Health

Let’s not sugarcoat it, cancer treatments can be brutal on the body. That’s the price we often pay for their effectiveness. But what many don’t realize is just how impactful these treatments are on one’s reproductive function.

Chemotherapy drugs, especially alkylating agents like cyclophosphamide, are quite strong. They don’t just target cancer cells. They can also kill off healthy eggs and sperm. Radiation, particularly when directed near the pelvis or brain, affects hormone control centers, damages reproductive organs, and alters hormone signaling. Surgical procedures may involve the removal of the uterus, ovaries, or testicles, depending on the cancer’s location.

These aren’t just temporary side effects. For many, the impact is long-term or even permanent. That’s why having a conversation about fertility preservation before treatment starts isn’t just wise, it’s vital.

Who Needs Oncofertility Treatment?

Anyone facing a treatment plan that might harm fertility should consider oncofertility services. This includes:

• Men and women diagnosed with cancers like leukemia, lymphoma, breast or testicular cancer
• Patients undergoing chemotherapy or radiation near reproductive organs
• Patients undergoing surgeries that involve the removal of reproductive tissues
• Patients with conditions like lupus or sickle cell disease requiring gonadotoxic medications
• Children with cancer, who may benefit from emerging options like tissue freezing

The Role of Fertility Preservation Before Treatment

Timing is everything in oncofertility. The ideal window for fertility preservation is before cancer treatment begins. Why? Because once treatment starts, the damage to reproductive tissues might already be underway.

Think of it like freezing a moment in time. Fertility preservation captures your current reproductive potential by freezing eggs, sperm, embryos, or even reproductive tissue before they can be altered by treatment. It’s a proactive measure, and in some ways, it’s a way to maintain hope. Knowing you have options for biological children in the future can provide incredible emotional relief amid the chaos of a cancer diagnosis.

Fertility specialists at Pacific Northwest Fertility often work quickly with oncologists to create a treatment plan that includes time for preservation. This collaboration ensures that preserving fertility doesn’t delay cancer treatment unnecessarily. With advances in technology and coordination, it’s often possible to complete egg retrieval, sperm collection, or tissue freezing within a matter of days.

Options for Women vs. Men

Fertility preservation isn’t one-size-fits-all. It differs significantly based on biological sex, age, and the type of cancer.

For Women

Cancer treatment can affect fertility in women in many ways. Methods that can combat this include:

• Egg Freezing. This is also know as oocyte cryopreservation, where mature eggs are retrieved from the ovaries and frozen unfertilized. This option is ideal for women without a partner or those not ready to create embryos.
• Embryo Freezing. In embryo freezing, eggs are fertilized with sperm (from a partner or donor), and the resulting embryos are frozen. This method has higher success rates than egg freezing, but requires a fertilization plan ready before moving on.
• Ovarian Tissue Freezing. This method is for prepubescent girls or women who can’t delay treatment for egg retrieval. A portion of ovarian tissue is removed and frozen for future transplantation.
• Ovarian Suppression. Here, hormonal injections are used during chemotherapy to potentially protect ovarian function. This method is still considered experimental and, as such, can be less reliable.

For Men

• Sperm Banking. For male patients, semen is collected and frozen. Ideally, multiple samples are gathered before treatment begins.
• Testicular Tissue Freezing. This method is an option for boys who haven’t reached puberty and can’t produce sperm. This option is still under research but offers future potential.

Both men and women have a range of options, but the key is speed and informed decision-making. The sooner these conversations happen, the more choices are available.

Choosing the Right Fertility Preservation Method

Thankfully, there is a spectrum of possibilities. However, choosing the right fertility preservation method depends on several factors, including your age, the urgency of cancer treatment, whether you have a partner, and your long-term family-building goals.

For example, a 29-year-old woman diagnosed with breast cancer who has two weeks before starting chemotherapy might choose egg freezing if she’s single. If she has a partner and wants to increase her chances of future pregnancy, embryo freezing might make more sense.

Conversely, a 15-year-old boy diagnosed with leukemia may not yet produce sperm. In that case, participation in a clinical trial for testicular tissue freezing could be a worthwhile discussion.

What’s most important is working with a fertility preservation team that can guide you through the options, not just from a medical standpoint, but emotionally and logistically. These decisions aren’t easy. Though they are sometimes made under pressure, with the right information, you can choose what’s best for you. 

FAQs

What is oncofertility?

Oncofertility is a specialized field within reproductive medicine that focuses on preserving fertility for cancer patients. It involves techniques like egg, sperm, and embryo freezing to allow individuals the chance to have biological children after undergoing cancer treatments that may impair fertility.

Does chemotherapy always cause infertility?

Not, chemotherapy doesn’t always cause infertility, but the risk is real. The outcome of chemotherapy depends on several variables:

• The type and dosage of chemotherapy drugs
• The age of the patient
• Fertility health before treatment
• Whether additional treatments, like radiation, are also used

Because it’s impossible to predict exactly how someone will be affected, fertility preservation is generally recommended before treatment begins.

Can I get pregnant after chemotherapy?

Yes, some individuals retain or regain fertility after treatment naturally. Factors like age, ovarian reserve, and overall reproductive health all play a role. However, for those who experience permanent infertility, frozen eggs, embryos, or even donor gametes and surrogacy are viable paths to parenthood.

A follow-up evaluation after treatment is key. This evaluation will look at hormone levels and reproductive function to help determine your chances of natural conception.

Is fertility preservation covered by insurance?

Insurance coverage varies widely. Some states mandate fertility preservation coverage for cancer patients. Some private plans include benefits for medically necessary procedures like sperm or egg freezing. But many do not.

Fortunately, many cancer centers and reproductive clinics offer sliding-scale fees, grants, or discounted programs. It’s essential to speak with a financial counselor or your insurance provider early in the process to clarify what’s covered and what’s not.

Final Thoughts

Oncofertility is a beacon of hope. When you’re grappling with a cancer diagnosis, the idea of losing your ability to have a child can feel like a second heartbreak. Oncofertility says, "Not necessarily."

It gives people the power to preserve something profoundly important: choice. The choice to be a parent on your terms, in your time, and for many, it’s the silver lining in a storm cloud they never asked for.