Your little girl has just been diagnosed with cancer. As a parent, you are devastated. You know she faces a long road of treatments, and you hope that at the end of that road, your daughter is cancer-free and ready to live her life. What you might not have considered is how her cancer treatments may affect her fertility and the ability to have a family, if she wants one, many years from now.
Washington University physician, Holly Hoefgen, MD, is a pediatric gynecologist who specializes in fertility preservation. She says, “When a young girl has a diagnosis of cancer, it may involve undergoing treatments such as chemotherapy or bone marrow transplant that would put her ovaries at risk for infertility in the future. The goal of our fertility preservation program at St. Louis Children’s Hospital is to meet with the young patients and their families and discuss the risks and reasonable options to preserve fertility.
Obviously, the cancer treatments are number one and most important to get the patient through her underlying disease, but we know there will be lasting effects and we want to make sure we are addressing those from the beginning.”
There are now options for fertility preservation that were not available even five to ten years ago.
Dr. Hoefgen explains fertility preservation techniques:
“For our teenage or young adult patients who have gone through puberty, we are able to harvest eggs from their ovaries. These are frozen and stored until the patient is ready to use them later in life – for many of our patients, that might be 10 or 20 years from the time we harvest the eggs. This is something that can be done, even for patients who need to begin cancer treatments relatively quickly.
But for our younger patients who have not gone through puberty, we must use more novel procedures to preserve fertility. All the eggs a female is born with are in the cortex of the ovary --- or the outside. We are able to take one whole ovary or strips of the cortex and freeze it (cryopreservation). When the patient has completed her cancer treatments and is ready to have children, we would put part of that ovary back into her body for the purpose of fertility. Within a few months, the young woman should regain her hormone function and be able to attempt pregnancy.”
Dr. Hoefgen wants to make sure the young girls and their families are informed of the risk and know that options may exist. But it is also important to be realistic and know that not every solution is available to all patients. There are other ways patients could have a family, and she talks about those alternative solutions, as well.
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For more information about fertility preservation, or to make an appointment with Dr. Hoefgen, please call 314-273-4PAG (4724)
Barnes-Jewish Center for Outpatient Health
4901 Forest Park Ave., Suite 710
St. Louis, MO 63108