For cancer patients already facing an overwhelming number of decisions upon receiving a troubling diagnosis, one medical team at the University Health System’s Center for Reproductive Medicine hopes to make having children a possibility — and a priority.
Senait Fisseha, clinical assistant professor in the University’s department of obstetrics and gynecology, leads a team off campus at the Briarwood medical complex to help patients with fertility-threatening conditions.
Fisseha said a study conducted by the American Society of Clinical Oncology — a professional organization of cancer-treating physicians — revealed that while nearly 70 percent of oncologists surveyed said they had discussed the issue of fertility with their cancer patients, only 25 percent referred a patient to a fertility preservation specialist for counseling and preservation services.
In 2006, ASCO developed a guideline requiring fertility preservation counseling prior to gonadotoxic treatment — that is, treatment which has a harmful effect on the ovaries or testes — a new standard of care for cancer patients of reproductive age.
But according to Fisseha, “a large number of patients who still need counseling are not getting the opportunity.”
At the Center for Reproductive Medicine, fertility preservation services include sperm, egg, ovarian and testicular tissue and embryo freezing coupled with one-on-one counseling.
Fisseha said the process involves a combination of evaluation, counseling and outpatient procedure. The freezing of eggs, which is offered to women without current sexual partners, involves stimulation of the ovaries prior to the eggs being frozen and harvested. When the eggs are eventually thawed, they are fertilized with a partner’s sperm.
“When fertility is under threat, and single women don’t have partners, this is a great strategy to improve fertility,” she said.
While the center primarily serves cancer patients, services are available to any patient with a fertility-threatening condition, she added.
Fisseha, who is a reproductive endocrinology and infertility specialist, said a number of treatments for diseases can endanger future chances of fertility. Chemotherapy drugs and multi-drug therapies may severely damage reproductive organs, and for cancers of the ovaries or uterus, these organs may need to be removed entirely, she said.
Every patient reacts differently to drug treatments, and chemotherapy may not always cause infertility, according to the University Health System’s Comprehensive Cancer Center website. The sterilizing effects of radiation treatment depend on dose, delivery schedule and the patient’s age at the time of treatment, the website reports.
But for patients who opt for cryogenic preservation before undergoing treatment, reproduction can become an option once the patient’s health allows him or her to begin the process of starting a family.
Because the lifetime of a cryogenically preserved egg is indefinite, Fisseha said adolescents and teenagers facing cancer can also elect to have their eggs preserved prior to child-bearing age.
“We’re making a lot of advances in adolescent and adult cancers. We have greatly increased life expectancy in young women and men that have cancer,” Fisseha said. “For very young patients, they don’t know when they will want to have children, but they want a means to preserve their fertility.”
Greater life expectancies in cancer patients, as well as advances in research, have increased the popularity of cryogenic preservation in recent years.
Fisseha said the center, which has been offering fertility preservation counseling and services since 2003, sees patients from all across Michigan and neighboring states. She said she hopes to see the number of patients grow as fertility education and counseling become more readily available to patients before they undergo chemotherapy or other gonadotoxic treatments.
“The greatest progress that we need to make is making our patients aware that (fertility preservation) is an option,” Fisseha said.