Treatments and fertility

I have heard that chemo and all the different treatments now days are not quite like they used to be as in making people sterile. I am trying to get information on this because I would still like to have another child. My doctor said basically I should be fine but there is still that chance I wouldn't be able to have children. I've looked into harvesting some of my eggs but they don't take my insurance and there really is no way we can afford it all right now with all the other doctor bills slowly coming in here and there.

Has anyone had to deal with the topic of fertility and being treated for cancer or know someone? I would love to hear what your experiences are with fertility and chemo side effects.

-martha

I'm getting a Zoladex shot every 28 days. It's a hormonal protection that deactivates your ovaries so they don't get affected by chemo as much, however there's still no guarantee.

Thank you for this information. I am going to look into it and talk about this with my doctor.

Martha,

This has been such a difficult topic for me! My oncologist brought it up several times during our visits with her, and every time she mentioned if I wanted to think about the options I would broke out in tears. She did mention that it is not certain if I'd be able to have more children not only because of the treatment I'm going through but also because at my age it is naturally more difficult to get pregnant. By the time my treatment ends I'll be 36. She said I would need to wait two years to start trying to get pregnant (they don't want to take any chances of you being pregnant and the cancer coming back, and I guess the chances of return in the first couple of years are the greatest). She also mentioned harvesting my eggs but I didn't want to waste any more time and prolong the start of my treatment. Even though I decided not to have any more children, it is still very difficult for me to think that if I ever changed my mind I wouldn't be able to get pregnant. Considering that I don't know what my future holds, I thought it would be very selfish of me to have another child. What if the cancer does come back? Why worry about another child losing their mom? I know this my sound odd but that's just me - I worry a lot about "what if".... I'm so blessed to have my daughter, and she's taken the whole thing (me being sick, not feeling well, losing hair) so well... I want to focus on her and give her as much of me and my time as I can.

Talk with your doctor about your options before you start your treatment. I'm sure you'll make the right decision.

Kama

Kama,

I hear you. I worry too such much about the “what if”. Right now I am 36 and will be 37 when I finish. The odds aren’t in my favor but there is always that hope I cling to. I am very optimistic about all of this and will stay that way. I don’t know what will happen later on down the road, but I do know that my treatment will start soon and then after all is finished I can make informed decisions about my future. Thank you so much for sharing wtih me. I hate that we have to go through this!

-martha

Martha-
Most of the frequently used chemotherapy agents are not new; they've been around a long time. Point being, they are as capable of causing infertility as they always have been. Some of the newer agents, ones that aren't quite considered chemotherapy but rather immunotherapy or some other agents, these may not be as capable. But in Hodgkin's, the standard treatments feature chemo drugs that go back thirty years or more. The drugs in ABVD are not new, nor are they in BEACOPP or Stanford V.

Keep in mind that chemotherapy drugs work on cells that divide more frequently than other cells, which is why aggressive cancers respond to chemo but indolent ones don't. It's also why patients have so many side effects in places where cells divide quickly--- hair follicles, the entire digestive system, and the reproductive system--- because chemotherapy agents are killing those cells along with the cancer cells.

If you undergo chemo or radiation for Hodgkin's, no one can assure you that you'll still be fertile afterwards. You just don't know for sure. Not only that, but for many months afterwards, you could have a funky menstrual cycle that won't tell you anything about whether or not you're still fertile. You do need to speak to your doc and you should ask about ways to preserve eggs, etc because there are ways to do that, and there are groups that facilitate the process.

Ross

Thank you so much for the great information. I have talked a little bit with my doctor but will do more when I see him again on the 23rd of this month. My doctor has talked to me about my menstrual cycle and the possiblity of not being able to have children afterwards. He did give me information about preserving my eggs and I followed up on it, but right now the cost is just too much. I just hate the thought that cost gets in the way of something so precious. If you know of any organizations that help with this I would love to hear about it. Thank you again for your help!

i do not know how accurate this is, but i had read somewhere (a blog from a patient) that standford V was used sometimes instead of ABVD to help chances of saving fertility in women.
i am male and was urged to store my sperm if i wanted to just be safe.

I can't add to whether Stanford V or ABVD is safer inre fertility, but in general - and I hope I don't have to retract this, I'm on my itouch, the issue is with a class of alkylating agents-- dacarbazine in ABVD is one, and procarbazine, in BEACOPP and MOPP, especially. These are considered reasonable threats to female fertility.... I think.

Ok well the MedlinePlus pages for both dacarbazine and procarbazine note a likely interference in menstrual cycles in women and sperm production in men, however they also state that you shouldn't assume that you can't become pregnant or get someone pregnant while on these drugs.

So looking up the actual prescribing information for dacarbazine, and here's all it says about the issue in question.

dacarbazine

If the term "teratogenic" is new to you, get ready: A "teratogen" is the term used for any drug or virus that causes damage to babies while in the womb, and it derives from the Greek, translating rather literally as 'monster maker.'

Ross

yikes! Thanks though for doing the research for this information. Very interesting.