For those of us with ovaries, we have the most eggs we will
ever have while we’re still in the womb. We’re born with about a million of them and
that number only goes down from there. We’ll release about 300-500 of those eggs
throughout our lifetime, but there are lots of things that can make that number even smaller.
One of those things is cancer.
Now, cancer is a really scary thing and it’s
an overwhelming wave of tests, diagnoses, and treatment options. And then there’s the cherry
on top of all the extra stuff there is to worry about...stuff like fertility.
-What happens is that the chemotherapy
can cause the eggs that are currently active in the ovary to undergo basically
cell death. And that can lower a person's egg supply more quickly than what happens naturally.
-The word chemotherapy actually means any drug used to treat any kind of illness,
but in the context of cancer treatment, these are drugs that are targeted at eradicating cancer cells.
And these drugs may not only affect active eggs but can also degrade the backup pool of eggs
that’s stored in the ovaries for future ovulation. And chemo isn’t the only kind of
cancer treatment—the two other most common are radiation and surgery .
Then there’s options like immunotherapy, hormone therapy, bone marrow transplants,
and lots of other emerging medicines. Radiation in the pelvic area can also
directly harm your eggs.
And any destruction of hormone-regulating parts of the body, like the ovaries, can trigger some
pretty drastic changes, including the onset of menopause-like symptoms before age 40.
But the effect of any of these treatments really depends on the kind of cancer
you may be dealing with. Which in Betty’s case, it was acute lymphocytic leukemia.
-My oncologist told me if I would have not been diagnosed for two more weeks,
I probably would have not survived. That's how quickly it was escalating.
-Every kind of cancer is relatively unique, so treatment is going to be tailored to
the stage and type of the disease and the age and general condition of the patient.
So after hearing all of that, it’s understandable that fertility planning
is a pretty actually big part of someone’s cancer journey.
My oncologist explained that the chemo would
potentially put me in early menopause or give me issues conceiving. So he was very clear
on explaining to me what could happen and the possibility
of me having a child.
-Some of you may already know this,
but in my last relationship, my long-term partner was diagnosed with a really aggressive lymphoma.
Everything I just said about ovaries is also true for male reproductive equipment. Chemotherapy
can damage sperm and sperm-generating parts of the body, so before treatment,
he needed to consult a fertility specialist. For those with testes, that means deciding
whether you want to collect and store a sperm sample. But for those with ovaries,
it’s a little more complicated.
-There are a variety of options.
The most commonly used option is egg freezing, where a patient undergoes an ovarian stimulation
cycle to try to get all the eggs that are present in the ovaries for that month to grow together.
We would then do a procedure that's under sedation to remove those eggs from your ovaries. Just using
a needle that goes through the vagina takes about 15 to 20 minutes and you go home the same day.
And we can freeze all of the mature eggs that we get to use in the future either to carry yourself
or to be carried by someone else.
-And that whole process takes time,
like at least a couple of weeks.
An even more recent option is ovarian transposition.
This is where the ovaries are actually surgically moved higher up into the abdomen
so they’re out of harm’s way if radiation is being aimed in that direction.
The ovaries are moveable! Who knew, huh? Not me.
But sometimes, things actually progress too fast. Some patients, like Betty, don’t
have the luxury of time to explore all options before they urgently need to start treatment
for their cancer.
-Unfortunately, due to the rate of the cancer growing and how fast I was deteriorating,
I was given the option to freeze my eggs, but it would postpone treatment for two months
which would make my prognosis very bleak. So me and my ex husband made a decision
to go ahead with treatment because we already had our newborn.
-It’s a tough decision to face. Luckily, there are some exciting advancements on the horizon, like...
artificial ovaries. This is where the patient’s own ovarian tissue is removed and frozen,
a technique known as cryopreservation.
It can then be used to create a scaffold, seeded with their own ovarian follicles.
And all of this can then be prompted to function as an ovary and produce eggs
outside of the body. We’re livin’ in the future, dude!
It can then be transplanted back into the body, where the hope is that it could resume
function as a normal ovary again. This research is still in its early
stages and has only been trialed in lab animals so far, but it’s a promising future option.
Other experimental ovarian cryopreservation techniques have
been tried successfully have resulted in live human births.
Plus, something that’s just as important as these advancements
is who exactly will have access to them. -A patient has to be aware that these services
exist, if they don't ask for it themselves. And so empowering our cancer specialists to know about
the ways that we can assist patients to preserve their fertility, and just kind of spreading the
knowledge amongst the practitioners. -And we can’t forget that all of this
costs money. -I wish I could say that fertility preservation
was free. But there's also some great societies out there that provide grants for
patients to help offset some of the costs. And so we try to meet patients, you know, kind of where
they are to get them the care that they want.
And depending on the kind of cancer,
and the kind of treatment, experts recommend that cancer survivors wait anywhere from six months to
five years before trying for kids. The waiting period reduces the chance of a
cancer recurrence and gives the patient adequate time to recover, both physically and otherwise.
There are lots of folks who complete cancer treatment and go on to have
low-risk pregnancies and healthy children. Like Betty,
who got pregnant shortly after getting the green light from her doctor without any fertility help.
-I never expected to get cancer as a new mom at 30. I never expected to have a
second child after I was told that I possibly could not have another child. So stay positive,
do your research, figure out what you want for your life and your future and where you stand
and always always advocate for yourself because no one else is going to do it better than you.
-If you or someone you know is looking for support when dealing with blood
cancer, check out The Leukemia and Lymphoma Society. They provide patients with free,
one-on-one support and opportunities to speak with highly trained oncology professionals.
To learn more about them, check out the resources we’ve left in the description below.
Thanks so much for watching Body Language, if you want more topics from the series,
check out season one here. If there are any other health topics
you think we should cover, let us know in the comments below.
I really hope you learned something new in this video and I'll see you next time.