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Preserving Fertility of Women with Cancer Is Often Neglected

By Jeffrey Norris, UCSF Science Cafe | September 21, 2010

Cancer and infertility can be a double blow. Many women become infertile following cancer treatment. And because more women are living longer thanks to modern chemotherapy and radiation treatment, more are later discovering that they cannot bear children.

On the bright side, techniques to enable infertile women to bear children -- such as egg cryopreservation -- are improving at a good clip, according to UCSF researchers. Their perspective on the subject appeared online on August 24 in advance of print publication in the journal Nature Reviews: Clinical Oncology.

Prognostic tests to help evaluate infertility also have become better. One such test is an ultrasound exam to count egg-bearing follicles in the ovaries. Another is a lab test to measure blood levels of the hormone AMH. These tests may provide a better gauge of a woman's infertility risk than age or family history alone, according to the UCSF researchers.

"Most of us take for granted the ability to have children, but infertility is one of the great quality-of-life concerns for cancer survivors," says UCSF endocrinologist and fertility expert Mitchell Rosen, MD, senior author of the perspective. "We have an opportunity to preserve fertility."

Many Women Are Not Informed About Fertility Preservation

Rosen and colleagues earlier conducted a statewide survey to learn about the concerns or regrets of female cancer survivors in their reproductive years, and many women reported a lack of information and communication related to infertility risk and options for reducing the risk.

Most childless, young women diagnosed with cancer want to have children one day, according the UCSF authors of the perspective. But despite progress in identifying infertility risk and in treating infertility, at least one-third of women of childbearing age who risk infertility due to radiation or chemotherapy for cancer are never told about the possibility of freezing eggs or other techniques for preserving fertility, the authors report.

Rosen has created a multidisciplinary team that includes endocrinologists, a nurse coordinator, a genetic counselor, a psychologist and researchers.

"We are dedicated to improving the chance to build a family for patients that have been diagnosed with cancer," he says.


Read more at Jeffrey Norris, UCSF Science Cafe