Childbearing After Cancer
By Dr Roland Chieng (MBBS, MRCOG) , Associate Consultant,
Centre of Assisted Reproduction,
Singapore General Hospital

Cancer is a common disease. It occurs in all ages including the childhood and reproductive years. Advances in cancer therapy have improved the long term survival of young patients with malignancies. In fact, many childhood lymphomas and leukemias can now be cured. Thus, the number of young adults who desire parenthood after cancer treatment and cure has increased significantly.

However, cancer treatment sometimes carries adverse side effects, including loss of *gonadal function and sterility in both sexes. Frequently, these effects are temporary, with the return of function some time after treatment. In cases whereby these effects are permanent, the opportunity for subsequent fertility is lost.

Fertility preservation in males by sperm freezing has been well established. Sperms can be obtained by masturbation and stored before the cancer treatment begins. The frozen sperms can be used via assisted reproduction techniques to achieve future pregnancy.

Fertility preservation in young women has been limited to very few options. There are protective medications advocated for preserving ovarian function during the duration of the chemotherapy as well as freezing and storage of embryos obtained as in *IVF (In-vitro fertilization) treatment cycle. However, the application of these techniques has been limited. It is the advent of other new methods for preserving ovarian function and fertility that provides hope. Eggs and ovarian tissues can all be frozen and stored for future use. However, these new techniques and knowledge of the storage are still largely experimental and the application in real cases will require thorough assessment and discussion with the reproductive specialists.

Glossary:
Gonadal function – reproductive function that produces and releases ovary or sperm

In-vitro fertilization – the method of surgically removing an egg from the ovary using ultrasound-guided retrieval. The ovary is then mixed with sperm in a petri dish. Fertilisation is done in the laboratory and the resulting embryos are transplanted into the woman’s uterus (womb).

If you have questions about this topic, please contact the Cancer Helpline on tel: 6225 5655 or email cancerhelpline@nccs.com.sg