Preserving Fertility During Ovarian Cancer Treatment

"Fertility preservation is a consideration for young patients, since oftentimes removing the fallopian tubes is necessary for this type of surgery," says Dr. Daynelle Dedmond, gynecologic oncologist with Centura Health. Since doctors don't always know the extent of disease prior to operating, or whether or not they'll be able to preserve a woman’s ovaries (or even one ovary), Dedmond says she often refers women for evaluation by infertility specialists, who are usually reproductive endocrinologists. These specialists can assess a patient’s current fertility and also make recommendations on what can be done to preserve fertility when keeping the ovaries is not possible.

If a patient is unable, for whatever reason, to see an endocrinologist before treatment begins or surgery is performed, or if it's deemed unsafe to stimulate the ovaries with egg-ripening hormones prior to surgery, Dr. Dedmond explains that there are options that can be done at the time of surgery that may allow patients to become parents in the future. At a medical center where there’s a team a surgical oncologist, a gynecologic oncologist, as well as a robust reproductive endocrinology department the reproductive endocrinologist can be on standby to accept a normal-appearing ovary or a portion of an ovary, Dedmond says. “Doctors may be able to remove the ovary and have a portion of it given to a reproductive endocrinologist who can try to retrieve immature eggs that can be used at a later time, after [being] frozen, in order to help a patient conceive." Know, however, that this procedure is still considered experimental, and is not yet available at most institutions.

Of course, a surgeon’s priority during an ovarian cancer operation is to make sure the patient is cared for, that the cancer staging is accurate and that they’ve removed the tissue and samples necessary to make the final diagnosis.

If you're an ovarian cancer patient in your childbearing years, Dr. Dedmond recommends that you speak with your cancer care team about the possible fertility problems that might arise from your treatment, and what your future plans are for having a family. Don’t assume your doctor or nurse will initiate the conversation. But if having children is something that's important to you, make sure to bring the topic up, and ask for a referral to a reproductive specialist.

Depending on age at diagnosis, some women may not have been thinking about having children yet, or ever, but a cancer diagnosis may speed up these conversations and decisions. Because a barrage of information can be a lot to digest, and can feel overwhelming, think about bringing your partner or a friend to your doctor visits as a second set of ears, maybe to take some notes, to help you understand your options before undergoing your cancer treatment.

And don’t get too concerned with checking the success rates of conception using frozen eggs or even eggs matured from ovaries that have been removed. As Dr. Dedmond says, whatever the success rates are now, they may be very different five or ten or however many years down the road when you decide it’s time to start a family.

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