Pregnancy causes brain tumor

Having children and cancer: the important facts

 

Information on the author and / or the specialist advisor can be found at the end of the article.

Do I want to start a family or have more children? Young cancer patients have to deal with this question before cancer therapy - i.e. immediately after the diagnosis. Because the treatment that helps them beat cancer often affects fertility at the same time. Even if time is of the essence, it is important to address this important issue before starting treatment.

Maintaining fertility is important to patients

Maintaining fertility plays a major role for most cancer patients - as shown in a study in which patients were asked three to five years after cancer therapy: 76% of men and women surveyed who were childless at the time of cancer therapy, said they wanted a child. 29% of patients who have already had children wanted more. Around 93% of the patients felt healthy enough to become parents, and 63% of the patients wanted a child even if they died prematurely [1]. A conversation with the doctor can clarify to what extent the cancer therapy affects fertility and how it can be preserved if necessary.

Different treatment methods carry different levels of risk

Various treatment methods are used in cancer therapy: For example, during an operation, the tumor and surrounding tissue, which could be affected, are removed. Chemotherapy and radiation destroy the tumor cells. However, it is possible that healthy cells are damaged. If the ovaries, egg cells or sperm cells are affected, fertility can be impaired.

Include the desire to have children in the therapy decision

Not all therapies possible in a specific case lead to a reduction in fertility in the same way. On the one hand, the desire to have children can be taken into account when choosing a therapy. In the event that after cancer therapy is over, it is still likely that you will not have a child naturally, there are various additional measures available to women and men so that their wish to have children can still be fulfilled. However, this must be done before cancer therapy.

This includes, for example, the freezing of egg or sperm cells or ovarian tissue. "The latter is the only method that is also possible for very young girls - even before puberty, when no egg cells have yet been formed," explains Prof. Ralf, the reproductive specialist and head of the IVF and endocrinological laboratory at the Women's Clinic at Erlangen University Hospital Dittrich. Because childhood cancers, such as leukemia, can also make therapy regimes necessary, which can later lead to infertility [2].

Important questions about cancer therapy

When is the right time to have a child after cancer therapy? And how long does the body need to recover? These are common questions that many cancer patients ask themselves after treatment. There is no general answer for the right time, says the head of medicine and research at the German Breast Group (GBG) Forschungs GmbH and experienced specialist in breast cancer and pregnancy at the certified breast center in the Sana Klinikum Offenbach, Prof. Sibylle Loibl. This is always an individual consultation decision between doctor and patient, depending on many individual factors such as the specific course of the disease, the necessary cancer therapy, the risk of relapse and the prognosis, but also on the age of the patient.

Many women and men can naturally become pregnant again or have children after they have survived cancer therapy. The prerequisite is that the hormonal cycle and reproductive organs function fully again. Depending on the therapy and the age, the body needs different lengths of recovery time. In women over 35, for example, the ovaries need an average of six months after chemotherapy to be fully functional again. On the other hand, very young women could often get pregnant again immediately, says Loibl.

When the desire to have children is no longer possible in a natural way

If regular sexual intercourse does not lead to success in couples who want to have children after a certain period of time (about 1/2 - 1 year), if the cycle is irregular or remains completely, examinations should be carried out. For women, this usually includes a physical exam, cycle and hormone checks. In men, a sperm sample is checked for the number and quality of the sperm cells. These examinations provide information on whether the cancer therapy could have damaged the relevant organ systems for egg or sperm production and whether hormone stimulation, artificial insemination or another fertility treatment is useful.

Fertility treatment and adoption

For fertility treatment it is often necessary that fertility-preserving measures have been taken in advance of the cancer therapy (e.g. freezing of egg cells, ovarian tissue, sperm cells or testicular tissue). For cancer patients, depending on the findings, various methods of artificial insemination [3] can be considered:

  • In intrauterine insemination (IUI), previously donated sperm are introduced directly into the uterus via a catheter. This takes place at a time when the chance of successful fertilization is particularly good.
  • In in vitro fertilization (IVF), sperm and egg cells are brought together in a test tube. After fertilization, the cells mature for a few days and the best-developed embryos (max. Three) are transferred to the woman's uterus. After about two weeks it can be determined whether the woman has become pregnant.
  • The procedure of intracytoplasmic sperm injection (ICSI) is comparable to that of IVF. Only here the sperm is injected directly into the egg cell.

 

If pregnancy does not occur in this way, ovarian tissue removed before cancer therapy can also be transplanted back in order to increase the possibility that the ovary will again produce egg cells [2], [6].

If the fertility treatment remains unsuccessful, adoption may also be an alternative (up to a certain age limit). Information is provided by the adoption agencies of the youth welfare offices, the central adoption agencies of the state youth welfare offices and the recognized adoption agencies of independent organizations [3].

Suitable contact points

“Unfortunately, there is still no comprehensive guideline on the subject of fertility maintenance in Germany that could help both doctors and affected patients to make a decision,” says Prof. Dittrich. It is advisable to have fertility-preserving measures and fertility treatment carried out in facilities that specialize in cancer patients. This ensures that expert knowledge and the technical requirements for this special patient group are up to date and tailored to the specific cancer. Corresponding addresses in the respective residential area are listed, for example, on the website www.fertiprotekt.de. Even those who do not feel they have been adequately advised at the time of diagnosis will find competent contacts here.

Note the treatment costs

You should also find out more about the costs in advance. The health insurance companies only take over the artificial insemination process and other fertility-preserving measures to a very limited extent and only under certain conditions. [3], [4].

Fertiprotekt: http: //www.fertiprotekt.de*

* Fertiprotekt is a platform where oncologists and reproductive medicine specialists work closely together, continuously collecting and evaluating treatment data - which ultimately makes it possible to provide targeted advice on fertility-preserving measures for the individual types of cancer and to carry out state-of-the-art treatments. Various facilities such as university clinics, hospitals and private fertility centers that meet the relevant standards are connected to the network.

 

Find out more about the desire to have children and cancer:

Preservation of fertility in the case of cancer

Cancer therapies can reduce fertility. What options are there to still fulfill the desire to have children? We inform you.

Read more Maintaining fertility with cancer

Influence of cancer therapy on family planning

What effects do cancer treatments, such as surgery, radiation or chemotherapy, have on fertility? Information is available here.

Read more Influence of cancer therapy on family planning

 

(lb / cu)

Swell:
[1] Schover et al. Cancer, 1999, 86: 697-709.
[2] Interview with Prof. Dr. Ralf Dittrich on March 13, 2015
[3] http://www.familien-wegweiser.de, website of the Federal Ministry for Family, Seniors, Women and Youth (as of March 20, 2015)
[4] http: //www.fertiprotekt.de*
[5] Interview with Prof. Dr. med. Sibylle Loibl on March 12, 2015
[6] Donnez J, Dolmans MM, Pellicer A, Diaz-Garcia C, Ernst E, Macklon KT, Andersen CY. Lancet. 2015 Feb 7; 385 (9967): 506-7

Expert advisor:

Prof. Dr. med. Sibylle Loibl, Co-Chair of the German Breast Group and Head of Medicine and Research at the German Brest Group (GBG) Forschungs GmbH;

Prof. Dr. rer. nat. Ralf Dittrich, reproductive medicine and head of the IVF and endocrinological laboratory at the Women's Clinic of the University Hospital Erlangen

Last content update on: December 19, 2018

Last accessed on: May 20, 2021 8:52 am