It is a fact that patients diagnosed with cancer primarily focus on the treatment and the success of the treatment. Since oncologists and surgeons also focus on the planning of cancer treatment, the issue of protecting reproductive health is often not on the agenda in patient-doctor meetings. However, it is possible to preserve fertility with some methods to be applied before radiotherapy and chemotherapy! As long as these methods can be used before starting cancer treatment. Obstetrics and Gynecology and IVF specialist from Istanbul IVF and Women's Health Center, Op. Dr. Aret Kamar, He explains the effects of cancer treatments on reproductive health, and the questions about fertility preservation before chemotherapy or radiotherapy:
"Cancer has become one of the most common problems we encounter today. Stress, unhealthy nutritional conditions, preservatives in foods, smoking are the main factors responsible for the increase in cancer disease. In addition, the increase in early diagnosis opportunities, raising awareness of individuals to follow up on this issue, and technological developments for diagnosis in medicine cause us to encounter an increasing number of cases of cancer in the early stages.
The early detection of cancer often brings about a process that will result in healing and the issue of fertility preservation. Chemotherapy and radiotherapy used in cancer treatment destroy egg and sperm cells in the ovaries of women and testicles of men. Although it is dependent on the dose used, sometimes permanent menopause or complete disappearance of sperm can be encountered. Authorities state that after 6 cycles of chemotherapy, 40-10 percent of women under the age of 25 and 40 percent of those over 90 years of age may experience menopause, that is, the permanent cessation of ovulation. The same is true for men.
HOW IS THE EMBRIO FREEZED?
Current approaches in the topic of fertility protection; embryo freezing, egg freezing, ovarian tissue freezing, ovarian suppression, ovarian transposition and ovarian shield. The most successful method for preserving fertility stands out as 'embryo freezing' in married couples. In this method, the ovaries of the woman are stimulated. In the treatment, some drugs are added to keep the hormones at a certain level, and the eggs are collected when the desired size is reached. After they are combined with the male's sperm, the embryo formation is followed and the good embryos are frozen and stored. In unmarried people, egg freezing, ovarian tissue freezing or methods made to prevent damage to the ovaries from the treatment are used. Freezing sperm in men is easy.
PRESERVATION OF FERTILITY IN CANCER TREATMENT
In our country, there is still not enough awareness about the protection of fertility in cancer patients. If the egg and sperm tissues are preserved, the chance of getting pregnant and giving birth to a child will continue regardless of the age of the woman when the cancer treatment is finished. In women, the uterus does not lose its ability to become pregnant with age. So that; When eggs are frozen at a young age, the frozen egg is thawed and combined with sperm, even if the woman has reached menopause. Embryos can be placed after the uterus is prepared and pregnancy can be achieved. It is easy to obtain sperm in men; it just has to come to mind. Removal of eggs in women can be done after ovarian stimulation treatment. Since the drugs used to stimulate the ovaries are often feared because they are hormones, these treatments are not requested and the woman's right to have children in the future after cancer treatment is taken away.
WOMEN'S FERTILITY RIGHTS AND CANCER TREATMENT
It is possible to perform these treatments without fear in cancer patients, especially in hormone-sensitive breast cancer cases at young ages. Apart from the standard treatment, some drugs are supported during the treatment to prevent the increase of the estradiol hormone. Although many eggs are grown, the hormone estradiol is maintained at levels during the normal menstrual cycle. In this way, it is ensured that the treatment for stimulating the ovaries does not have any side effects on cancer. When the eggs are grown, they are collected under general anesthesia and stored frozen. It can be used at the end of cancer treatment at any time. Thus, the fertility right of the woman is not affected by the treatment. Sometimes there may not be enough time to stimulate the ovaries and collect eggs. In such cases, ovarian tissue is taken and stored. At the end of the treatment, the ovarian tissue is placed back into the female body and made functional. In this case, the woman is also protected from menopause.
FOR WOMEN, 15-20, FOR MEN, ONE DAY IS ENOUGH!
The methods used for the protection of fertility can be easily done in technical terms in our country. However, when cancer is diagnosed, the doctor wants to start treatment as soon as possible, and the patient wants to get rid of the cancerous tissue as soon as possible and does not think about the future. In this regard, it is necessary to raise awareness of doctors who deal with cancer treatment as well as patients. It is an important health problem that the sperm and eggs of cancer patients are not stored until after the treatment so that their living standards do not deteriorate at the end of the treatment.
The time required for egg stimulation, follow-up and egg collection is approximately 15-20 days. This is the duration of treatment for patients who will receive radiotherapy or chemotherapy after cancer surgery. Therefore, there is time required for egg collection. For men, the situation is much easier. It is a one-day process for the man to apply to a center to give sperm and freeze them for the future.
We predict that as treatment standards increase in the future, we will be more sensitive about egg and sperm freezing. Over time, this will be more applicable through training, awareness of the society and surgeons and oncologists dealing with cancer treatment. In this way, we will not be helpless against many couples who apply after cancer treatment.”
