The short answer
Fertility preservation means saving or protecting eggs, sperm, embryos, or reproductive tissue so having biological children may be possible later. These steps usually work best before cancer treatment starts, and a fertility specialist works with your cancer team on timing. Options differ for men and women, and cost and availability vary.
Fertility preservation saves or protects eggs, sperm, embryos, or reproductive tissue for the future.
It usually works best when arranged before treatment begins.
Options for men include sperm banking and other sperm-saving methods.
Options for women include freezing eggs or embryos and protecting or moving the ovaries.
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The full explanation.
What fertility preservation means
Fertility preservation is the process of saving or protecting eggs, sperm, embryos, or reproductive tissue so that having a biological child may be possible in the future. According to the National Cancer Institute (NCI), many of these methods are forms of assisted reproductive technology — treatments and procedures that help a person achieve pregnancy.
These services may be available at the hospital or cancer center where you receive treatment, or at a fertility clinic.
Why it works best before treatment
The most effective options usually happen before cancer treatment begins. If you choose to preserve fertility, your cancer team and a fertility specialist work together to build a treatment plan that includes it. They also advise on the timing and on whether delaying the start of cancer treatment for a preservation procedure would matter in your case.
Because treatment can affect the reproductive cells and organs these methods rely on, raising the topic early keeps more choices open.
Options for men
NCI describes several methods for males:
- Sperm banking (sperm cryopreservation) is the most common method for males who have gone through puberty. Semen is collected, then frozen and stored for the future. Sperm can be frozen for an indefinite time and later used in IVF.
- Testicular shielding places a protective cover on the body to shield the testicles from scatter radiation during radiation therapy.
- Testicular sperm extraction (TESE) and testicular sperm aspiration (TESA) are procedures that retrieve sperm cells directly, which can be frozen or used to fertilize eggs.
- Testicular tissue freezing is an option being studied for boys who have not gone through puberty or men who cannot give a sperm sample.
Options for women
NCI describes several methods for females:
- Embryo freezing uses fertility drugs to mature eggs, which are collected, fertilized with sperm in the lab to form embryos, and frozen for later use through IVF.
- Egg freezing removes and freezes mature eggs, which can later be thawed and fertilized.
- Gonadotropin-releasing hormone agonists (GnRHa) are drugs that cause the ovaries to quiet down; they are sometimes used with breast cancer treatment.
- Ovarian shielding uses protective shields to reduce scatter radiation to the ovaries.
- Ovarian tissue freezing removes and freezes ovarian tissue, which can later be placed back in the body.
- Ovarian transposition (oophoropexy) moves the ovaries away from the area receiving radiation.
- Radical trachelectomy is a fertility-sparing surgery for some early-stage cervical cancers that removes the cervix but leaves the uterus in place.
Cost, coverage, and support
NCI notes that the success rate, cost, and availability of these procedures vary. Some states require insurance companies to cover fertility preservation for people with cancer. Organizations such as the Oncofertility Consortium, the Alliance for Fertility Preservation, and Livestrong Fertility offer information, patient navigators, and help with cost. A social worker or patient navigator on your team can also help you find resources.
Words to know
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Common questions
▸What is fertility preservation?
It is the process of saving or protecting eggs, sperm, embryos, or reproductive tissue so having a biological child may be possible after cancer treatment. Many of these methods are forms of assisted reproductive technology.
▸Why do it before treatment?
The most effective options usually happen before treatment begins, because treatment can affect the reproductive cells and organs the methods rely on. Asking early keeps more options open.
▸What are the options for men?
Sperm banking (freezing sperm) is the most common method for men who have gone through puberty. Other options include testicular shielding during radiation and procedures that retrieve sperm or freeze testicular tissue.
▸What are the options for women?
Options include freezing eggs or embryos, ovarian shielding or transposition during radiation, ovarian tissue freezing, and, for some early cervical cancers, a fertility-sparing surgery. A fertility specialist can explain what fits.
▸Does insurance cover it?
Coverage, cost, and availability vary. Some states require insurance companies to cover fertility preservation for people with cancer, and support organizations can help with information and cost.
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