It is believed that cancer rates will reach 16 million people worldwide up to 2020, being approximately 70 thousand diagnoses registered every year in the United States alone in people from 19 to 35 years of age.
It is very important to emphasize that before anything else, take care of fertility does not mean harm or delay oncological therapy, but the possibility of a second chance for the patient, which will allow that once cured from the cancer, the fertility can be reestablished and the quality of life renewed.
Preferably preservation of fertility must be executed before the specific cancer therapy, always taking into consideration the patient’s age, existent cancer diagnosis, and oncological therapy schedule.
In the event of patients already submitted to oncological therapy or currently undergoing therapy who wish to have children, the best indication is an evaluation by the Oncofertility specialist so that the best instructions and treatment alternatives can be assessed.
Medical advancements and drugs used in the treatment of oncological patients have been more and more effective in the cure and good prognosis of cancer patients in a way that together with the earliest diagnosis, the number of survivors increases exponentially every year. It is estimated that over 13 million former cancer patients are today cured in the United States alone.
After the cure, the quality of life becomes the main focus to be considered in the treatment of those patients and recent studies show that most cured patients have building a family as the main objective regarding quality of life.
The use of chemotherapy and/or radiotherapy, regardless the dose or radiation used injures germinative cells in the gonads (ovaries and testes). Germinal cells, both male and female, are responsible for fertility. Therefore, treatment for the cure of cancer affects both ovary and testicular functions.
Women are born with a total number of pre-determined oocytes in their ovaries and, after the first period, several follicles present in the ovary are monthly recruited to establish the dominant follicle that will grow and reach maturity and, then ovulate, while the others start atresia and degenerate. This natural cycle takes place until the woman reaches menopause and, then, exhaust the number of existent follicles. Chemotherapy and radiotherapy “cause” early menopause, speeding follicular atresia and reaching primordial follicles, causing infertility in the patients treated.
In men, the production of sperm is basically renewed every three months due to the maintenance and differentiation that takes place in the testicular cells present during almost the entire life of a subject, in a process known as spermatogenesis. However, chemotherapy and radiotherapy treatments promote the death of testicular cells responsible for spermatogenesis, promoting infertility.
Once the oncological treatment is completed, fertility is compromised in 90% of the cases and it can be permanent or temporary depending on the doses and types of chemotherapies, radiotherapy range used, type of cancer, compromised organs, and even the response of each individual.