Oncofertility

Oncofertility is a subfield that bridges

Cancer treatments, such as chemotherapy, radiation, and surgery, may destroy a person's ability to have children later in life, and oncofertility research focuses on increasing fertility preservation options. With 10% of cancer patients being younger than age 40, this issue affects more than 135,000 people in the United States each year. As cancer survivorship increases, the preservation of fertility in women, men, and children becomes a critically important topic to patients and their families. The ability to easily preserve fertility prior to cancer treatment can provide hope at the time of diagnosis for families later in life. Oncofertility also incorporates reproductive issues after cancer treatment, such as family planning, complex contraception, hormonal management throughout survivorship, surrogacy, and adoption.

Fertility options for men

Established fertility preservation options for men include sperm banking, in which a semen sample is produced, frozen, and stored for future use,^[1] and testicular sperm extraction, during which sperm is retrieved directly from the testes through a short surgical procedure and frozen. ^{[citation needed]}

Experimental options include testicular tissue banking when testicular tissue is surgically removed and frozen. Scientists are developing methods to use this tissue for fertility preservation in males. ^{[citation needed]}

Men who do not preserve their fertility prior to cancer treatment may have children through

Options for women to have children after cancer have increased significantly in recent years.

Experimental techniques include ovarian tissue banking in which an ovary is surgically removed and frozen to be transplanted back into the woman when she is ready to have children. Scientists are also working on ways to mature undeveloped eggs from this ovarian tissue. ^{[citation needed]}

After sterilizing cancer treatment, permanent damage to the uterus could be sustained.^[4] A woman can also choose surrogacy (when a woman carries a pregnancy for another woman or couple) or adoption. ^{[citation needed]}

Recent efforts also investigate the implications of a cancer diagnosis during pregnancy.^{[citation needed]}

Fertility options for children

Prepubescent children have fewer options to preserve fertility than adults.^[5] These include testicular sperm extraction for males and ovarian tissue banking for females.

Financial, ethical, and legal considerations

Fertility preservation costs may be prohibitive for young patients and multiple organizations now provide methods to reduce costs for patients.^[6] These include Fertile Hope and Fertile Action.^{[citation needed]}

The Supreme Court of the United States addressed the Social Security implications of oncofertility in March 2012 with Astrue v. Capato.^{[citation needed]}

Research also investigates ethical issues in oncofertility, such as the decision-making process for adolescent children and their families.^[7]

References