Abhishek Aggrawal, Chief Business Officer, Birla Fertility & IVF, C.K. Birla Group emphasises that while guidelines recommend initiating discussions on fertility preservation before commencing cancer treatment, there is a noticeable gap in practical implementation. To address this and strengthen awareness among patients, a multidisciplinary approach consisting of both oncologists and reproductive specialists is needed
The arrival of a child can transform one’s life. Yet, for individuals with cancer – the journey can be emotionally draining and demanding. Annually, more than 140,000 individuals diagnosed with cancer are in their reproductive years, meaning they are up to 45 years. Of this, an alarming 40-80 per cent of females undergoing cancer treatments, including chemotherapy, radiation, and surgery, confront potential infertility. Therefore, recognising the rising significance of fertility preservation is pivotal in enhancing the overall quality of life for cancer survivors. While guidelines recommend initiating discussions on fertility preservation before commencing cancer treatment, there is a noticeable gap in practical implementation. To address this and strengthen awareness among patients, a multidisciplinary approach consisting of both oncologists and reproductive specialists is needed.
Fertility preservation in India: Opportunities and challenges
Awareness around the evolving landscape of onco-fertility is needed – so that a supportive, informed, and inclusive environment for cancer patients and couples navigating fertility issues can be fostered. The advent of medical marvels such as fertility preservation presents a ray of hope for women battling with cancer. It is a new branch of medicine that helps cancer survivors protect their fertility. There has been considerable progress in the field of fertility preservation technologies. Assisted reproductive technologies (ART), such as oocyte cryopreservation (egg freezing), ovarian transposition, and ovarian tissue freezing, among others have emerged as effective methods for preserving fertility in women undergoing cancer treatment. These innovative techniques make it possible for cancer patients to freeze their eggs before undergoing chemotherapy or radiation therapy, thereby preserving their reproductive potential for the future.
Oncofertility: Fertility preservation in cancer patients
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Egg freezing
Since the late 1990s, egg freezing has been used an option by women, suffering from cancer, to preserve their fertility from the side effects of the disease and its treatment. Due to the advancements and availability of clinics offering the service, egg freezing has now become increasingly popular in India. It provides three significant advantages to women with cancer – first, it offers the opportunity to become a biological parent at a later stage, it also reduces the likelihood of babies with chromosomal irregularities (due to the chemotherapy) and alleviates the stress and anxiety associated with the biological clock, by securing reproductive options for the future. It is important to note, egg freezing is a preferable choice for women without partners or those uncertain about starting a family with their current partner. However, if one is confident in their partnership or are married, embryo freezing presents a more favourable option due to its higher likelihood of success.
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Embryo Freezing
Embryo freezing or cryopreservation offers cancer patients the opportunity to preserve their fertility by storing embryos for future use. This technique enables individuals to undergo cancer treatment without incurring the risk of infertility afterwards. By freezing embryos, patients can retain their reproductive options and pursue parenthood when they are ready. It provides peace of mind and reassurance during a challenging time. Additionally, embryo freezing has a high success rate in achieving successful pregnancies.
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Ovarian Cortex Freezing
Ovarian cortex freezing offers young women, who have not yet reached puberty, undergoing cancer treatment the chance to protect their fertility by preserving ovarian tissue (as eggs cannot be retrieved). This method provides hope for future fertility by safeguarding the ovaries’ ability to produce eggs. By preserving ovarian function, women can retain their reproductive options after cancer treatment. This procedure empowers women to pursue motherhood beyond their cancer diagnosis.
Looking ahead: The need to integrate fertility preservation into cancer care
Cancer treatments, while lifesaving, can have detrimental effects on the reproductive organs of women. Therefore, it is imperative for medical experts to prioritize fertility preservation as part of comprehensive cancer care. It is crucial to empower cancer patients with the right information and support regarding fertility preservation options, ensuring that they can make informed decisions. Fertility preservation for them is not just a medical intervention, but a critical factor in ensuring that they have the opportunity to conceive in future, despite their cancer diagnosis.