Saving Fertility When Cancer Strikes
Fertility Report Issued by the American Society for Reproductive Medicine
June 10, 2005 -- More and more people are surviving cancer, and many may
want to preserve their fertility in the wake of cancer treatments.
That's the topic of a new report from the ethics committee of the American
Society for Reproductive Medicine. "Cancer treatment often results in
reduced fertility," according to the committee's report, published in
June's issue of Fertility and Sterility.
However, reproductive technology may help preserve fertility if cancer
treatment brings unavoidable damage to the reproductive organs. For instance,
when cyclist Lance Armstrong learned in 1996 that he had testicular cancer that
had spread to his lungs and brain, he banked his sperm before treatment in the
hopes of having children later on. He and his former wife, Kristin, now have a
son and twin girls conceived through in vitro fertilization from those
Some techniques -- like freezing sperm and embryos -- are well established,
while other methods (like freezing unfertilized eggs and ovarian tissue) are
still experimental, says the committee.
The report makes seven main points:
- Doctors should tell cancer patients before treatment about options for
fertility preservation and future reproduction.
- Sperm cryopreservation in men and embryo cryopreservation in women are the
only established methods of fertility preservation.
- Experimental procedures, such as egg or ovarian tissue cryopreservation,
should only be offered in an appropriate research setting.
- Concerns about the welfare of resulting offspring should not be cause for
denying cancer patients assistance in reproducing.
- Parents may act to preserve the fertility of cancer patients who are minors
if the child assents and the intervention is likely to provide net benefits to
- Precise instructions should be given about the disposition of stored
gametes, embryos, or gonadal tissue in the event of the patient's death,
unavailability, or other contingency.
- Preimplantation genetic diagnosis to avoid the birth of offspring with a
high risk of inherited cancer is ethically acceptable.
The committee members say they wrote their report as a service to the
society's members and other doctors. However, they say it "is not intended
to be the only approved standard of practice or to dictate an exclusive course
of treatment in all cases."