What Aspiring Mothers With Ovarian Cancer Can Do To Preserve Fertility
Cancer, in its many forms, has aggrieved millions around the world. Among various forms, ovarian cancer is the third most common gynaecological cancer in Indian women after breast and cervical cancer. Females have a pair of glands, called ovaries, that are filled with eggs that, when fertilised by a sperm, can develop into an embryo.
Ovaries play a vital role in preserving homeostasis throughout a female's lifetime by assisting in the maintenance of various hormone levels, including oestrogen and progesterone. However, the organ is also prone to disease like cancer. Ovarian cancer seldom manifest any major symptoms; which can lead to a delayed diagnosis and problems over the course of treatment process.
For those who have been diagnosed with cancer, chemotherapy, radiation and hormonal therapy are among the widely used options. They work by effectively killing cancerous cells or by blocking cellular pathways that lead to the formation of cancer cells. However, a known side-effect of these powerful treatments is that healthy body cells may also get damaged along with the cancer cells.
These healthy body cells can be gametes, that is, eggs in females especially when the treatment is for ovarian cancer. Damage in the morphology or genetic information of gametes make them unfit for conceiving, therefore, many a times, cancer patients may also become infertile. Treatment options for these genital cancers can include removal of parts or whole organs, making an unassisted pregnancy improbable in the future. These individuals may have to opt for donor gametes, donor embryos or pregnancy via surrogacy.
Advancements in science have also helped address the problem of person who have undergone radiation/chemotherapy treatment with a solution – egg and sperm freezing.
Preserving fertility in ovarian cancer patients
The technique for preserving fertility in people affected by ovarian cancer varies from person to person – this depends on the kind of cells that are cancerous, when the disease was detected and how much it has spread in either or both ovaries, and the treatment suggested. If the disease is discovered early on, egg freezing is a champion technique that can safeguard eggs which can be collected before starting with treatments such as chemotherapy. Alternately, modern medicine has found ways to develop germ cells, which are primordial, basic entities, into eggs. Eggs obtained by these methods can be used by the female herself after the disease has been conquered; IVF becomes integral here.
Egg freezing give women the power to delay childbearing to a later time. They can choose to store their eggs when they’re younger – preferably late 20s to early 30s – because this is when they are robust and more in number. Cancer patients can choose to store their eggs before embarking on cancer treatments when they are still in good numbers and of better quality. The procedure first entails consultation with the oncologist and a fertility specialist who can take the patient through the process. These patients may be young who have no children but plan to start a family in the future; they may also already have children and would like to further expand their family.
Women undergo a few tests and are then injected with hormones so multiple eggs may develop inside the ovary. This is observed through ultrasound and developed eggs are retrieved by a seasoned embryologist. It is suggested that at least 15 eggs be extracted and stored to increase the chances of a successful pregnancy later. Once samples are collected, they are stored inside vials at -196˚C in liquid nitrogen. Gametes thus frozen can be preserved for 10-20 years, and people can choose to thaw and use them when they are mentally, financially, and physically ready to have children. For cancer survivors who would like to become parents in the future, this technique ensures that they do not have to face added complications with fertility after conquering the disease.
There are now more novel and interesting techniques such as ovarian freezing which cryopreserve these gamete-producing tissues. However, egg freezing, especially, has proven to be an empowering tool for females in both developed and developing nations who aspire for motherhood after undergoing cancer treatment. No matter what the extent of the spread is, it is imperative that women with ovarian cancer have conversations with doctors about their aspirations and motherhood dreams.
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