By 2022, more than 8,200 Australians under the age of 40 who are of reproductive age are expected to be diagnosed with cancer. That’s more than double his rate in the 1980s.
The good news is that more men, women and children are surviving cancer than ever before. This is due to earlier diagnosis and more success. cancer treatment.
Today, more than 85% of patients under the age of 40 are still alive five years after being diagnosed with cancer.
However, many of them may be unaware of the possible decline in fertility after cancer treatment and the options available to protect their ability to have children in the future.
Some estimates suggest that only half of cancer patients have a documented discussion of fertility preservation.
Effects of cancer treatment on fertility
cancer and both treatment May reduce fertility in all genders. Chemotherapy, radiation therapy, and surgery can permanently reduce the number of egg and sperm cells, making future pregnancies difficult.
Egg stores are laid down before birth and to date there is not enough evidence that eggs can be replenished.
Chemotherapy – chemical treatments that attack cancer cells – can harm and reduce the number of delicate egg and sperm cells.
Similarly, radiation therapy (radiation energy directed at cancer cells) can scatter and cause scarring of ovarian and testicular tissue.
High-dose chemotherapy or radiation therapy can destroy all eggs, sperm cells, and supporting tissues. Direct surgery on the reproductive organs can lead to decreased fertility.
In many cases, it is not known what the full effect of cancer treatments will be fertility,In effect there are individual differences.
What is tumor infertility and how can it help?
Oncofertility is a relatively recently established medical field that offers fertility-sparing options.
Addressing quality of life from a biological, psychological, and social perspective recognizes the potential distress that reduced fertility can cause cancer survivors.
Advances in assisted reproductive technology such as vitrification (rapid freezing) have made it possible to preserve eggs, embryos, ovarian tissue, sperm and testicular tissue for future use.
This is known as medical fertility treatment.
Fertility preservation may be the best chance for a biological child in the future. Oncology infertility considers an individual’s future goals as a family and parent, along with cancer treatment.
4 new things we know about tumor infertility
This year, the Australian Society of Clinical Oncology (COSA) updated its guidelines for fertility preservation in cancer patients.
It is based on advice, public consultation and feedback from Australian experts including medical professionals, scientific researchers, psychologists, health care providers and nurses.
COSA guidelines describe fertility treatment options, referral pathways, and psychological support. It also covers contraception during cancer treatment (to avoid interrupting the treatment plan), interruption of hormone therapy for pregnancy, assisted reproductive technology, and the risk of cancer recurrence.
This guideline is intended to support conception and pregnancy in cancer survivors.
A paper published today in the Australian Medical Journal updates physicians on the latest in oncology infertility knowledge. In other words, the pregnancy rate after egg freezing is almost the same as the pregnancy rate after embryo freezing, with live birth rates of 46% and 54%, respectively.one study ovary Although tissue freezing and transplantation in women is no longer considered “experimental,” special oversight is recommended for prepubertal girls under the age of 13.
This is because there is limited clinical experience in patients under the age of 20 during fertility preservation, and microsurgery is not recommended for men who have already undergone cancer treatment and were previously thought to be sperm-free. Extraction of sperm from testicular tissue by cytotoxicity may be considered. Freezing testicular tissue in prepubertal boys is currently considered “experimental” because there are no mature sperm cells. Clinical and ethical oversight is required while new methods to use these early cells for fertility are being tried.
Fertility discussions and decisions can be urgent and time-critical after a cancer diagnosis is made.
This is to allow time for oncology fertility referral, appropriate counseling, and informed decision making.
Because fertility-sparing planning and execution takes time (for example, it can take about 14 days for an egg to grow and be collected for freezing), promptness is critical to prevent cancer treatment delays. is important.
Not everyone of childbearing age who is diagnosed with cancer is immediately referred to oncology fertility services. This can lead to feelings of conflict and regret.
A team of fertility specialists at Royal Women’s and Royal Children’s Hospitals, in partnership with the Western and Central Melbourne Integrated Cancer Service, have developed a series of animated patient education videos that address this gap.
The Ferility after Cancer Video – Available in Multiple Languages, Review cancer patient Age-appropriate support groups for children, adolescents, adults, and their families – Discuss options, risks, benefits, and alternatives for fertility preservation.
Our goal is to ensure that all cancer patients in Australia have access to information and support regarding the impact of cancer treatment on their future fertility.
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