Planning for life beyond a cancer diagnosis: Clinicians offer options to protect fertility prior to cancer treatment

"When my doctor suggested I consider in vitro fertilization (IVF), I was taken back. I hadn't really thought about kids. We just got engaged and I was scared that I wasn't even going to see my wedding day. The last thing on my mind was starting a family," said Scott.

While Scott was consumed by her diagnosis, her doctors were looking to the future. "When a woman, man or teenage girl or boy is diagnosed with cancer, there is only a brief window of time to learn about options for preserving their fertility before treatment," said Ralph R. Kazer, MD,reproductive endocrinologist at Northwestern Memorial and professor of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine. "Once a patient begins chemotherapy or radiation, they are at risk of losing their ability to have children in the future."

When Scott realized there was a good chance that chemotherapy would leave her infertile she and her fiancé opted for emergency IVF. Doctors at Northwestern Memorial worked quickly to harvest her eggs, fertilize them with her fiancé's sperm and freeze them for use later in life. The outpatient procedure was completed in a couple weeks, a process that usually can take more than a month.

Five years after making that life-changing decision, Scott is cancer-free, married and the mother to twin baby girls, Addison Grace and Avery Jane. "They are my entire world," said Scott. "I am grateful I chose to preserve my embryos and more importantly, that the option was presented to me. If my doctor hadn't mentioned fertility preservation, I may not have been able to have kids and experience the joy I have today."

At the time of her diagnosis, Scott was one of the first patients to take part in the Northwestern's Fertility Preservation Program. The term oncofertility, which describes the intersection of oncology and reproductive medicine, coined by Teresa Woodruff, PhD, Chief of the Division of Fertility Preservation in the Department of Obstetrics and Gynecology, was new, and only a small percentage of oncologists were partnering with reproductive endocrinologists to offer options such as emergency IVF prior to cancer treatment. Over the last five years, the program has rapidly advanced and fertility preservation is more commonly discussed, allowing men, women and even adolescents, the option to undergo fertility saving procedures prior to cancer therapy.

At Northwestern Memorial, a dedicated fertility preservation patient navigator guides newly diagnosed cancer patients through a hopeful process -- preserving their future ability to have children in the face of life-saving, yet fertility-threatening treatments. Northwestern Memorial in partnership with Feinberg School of Medicine is the first group in the world known to offer a dedicated fertility preservation patient navigator.

"In the past, when a patient was diagnosed with cancer the only focus was to get them into surgery and through chemotherapy or radiation. It's my job to make sure each patient understands the consequences certain therapies may have on their fertility, so they can make an informed decision regarding whether or not they wish to undergo fertility preservation prior to treatment," said Kristin Smith, fertility preservation navigator in the Department of Obstetrics and Gynecology and the Robert H. Lurie Comprehensive Cancer Centerof Northwestern University at Northwestern Memorial.

Research at Northwestern has expanded the options for fertility preservation over the years, which now includes freezing ovarian tissue and sperm extraction in addition to embryo, egg and sperm banking. Northwestern researchers continue to explore several other fertility preservation techniques.

"Many younger patients with cancer are surviving and living healthy long lives. It's our job to do everything possible so patients can look forward to a life that looks as much like the life they had planned on before the day they were diagnosed," said Woodruff, who also developed and is principal investigator of the national Oncofertility Consortium, a National Institute of Health (NIH) funded network of doctors and scientists working to provide improved fertility preservation options for people diagnosed with cancer and other diseases.