Infertility after treatment: surrogacy for cancer survivors
Women that have recently been diagnosed with cancer often consider egg freezing also called oocyte cryopreservation, ovarian tissue freezing, or creating embryos before treatment begins. For men, sperm banking is done prior to undergoing chemotherapy or radiation as these procedures can damage sperm production or lead to infertility. If you know you want to have biological children in the future, storing eggs, ovarian tissue, sperm, or embryos can enable you to become a parent after your cancer treatment ends. With cancer, however, timing is key, so you’ll want to discuss your fertility plans with your oncologist before delaying treatment.
Egg Freezing
There are some things to consider as you ponder freezing your eggs before beginning your cancer treatment:
- Consult with a board-certified physician who deals with reproductive endocrinology and infertility that has direct experience working with cancer patients. Fertility specialists can provide you with the best approach given your specific cancer treatment plan.
- Consider the urgency of beginning your cancer treatment. Depending on when treatment needs to start, you may need to expedite egg freezing. Tell your oncologist about your family-planning concerns and make sure he/she is on board with the schedule.
- Before beginning the process of egg freezing, a fertility specialist will need to perform tests to ascertain the potential viability of your eggs. He/she will factor in age, health, and hormone levels to determine the expected quality and quantity of your eggs. If it’s unlikely that you’ll have success with egg freezing, he/she may suggest using an egg donor for future family-building.
- Egg freezing can be expensive as the process includes medications, a surgical procedure, and cryopreservation storage fees. Private insurance may not cover all or any of the costs.
Ovarian Tissue Freezing
Ovarian tissue cryopreservation is a completely different Assisted Reproduction Technology approach. With ovarian tissue freezing, a portion of an ovary is removed and frozen for future replantation after cancer treatment has concluded. The advantage of this technique, just recently moved outside of “experimental” procedure status by the American Society of Reproductive Medicine, is that it preserves natural fertility as well as a woman’s ability to make important reproductive hormones such as estrogen and progesterone.
The first successful use of this technique occurred in 2000, with success rates increasing over the last 2 decades. If you decide to use frozen ovarian tissue cryopreservation, once you are ready to become a mom, the stored tissue is implanted back into your body via a transplantation procedure. If all goes well, the replanted tissue will function again and produce hormones and eggs.
When considering egg freezing vs. ovarian tissue freezing, consult with a qualified fertility specialist that has experience guiding cancer patients. Your age, type of cancer, and cancer treatment plan may help determine whether egg freezing or ovarian tissue freezing is the best option for you.
Embryo freezing
Folks with long-term partners or spouses often consider creating embryos prior to the commencement of their cancer treatment. Embryos are created using a technology that has been evolving almost 40 years, In vitro fertilization (IVF).
You will need to discuss all of your options with a board-certified fertility specialist to identify the best fertility preservation method available to you.
Sperm banking
Sperm cryopreservation is a popular method of preserving future fertility in men before they undergo cancer treatment. It’s a fairly straightforward process: a semen sample is obtained, placed into a sterile container, and then frozen and stored in liquid nitrogen. The collected sperm is then analyzed for motility, morphology, and overall count. Depending on the results, intrauterine insemination (IUI) or In vitro fertilization (IVF) may be used to father future children.
Because sperm can be stored indefinitely at a sperm bank or a fertility clinic, it’s a popular option for many men regardless of their age. To find out if sperm banking is the right step towards preserving future fertility, speak to a qualified fertility specialist.
Surrogacy for Fertility Preservation
Surrogacy can be a viable and desired option for cancer survivors that are no longer able to carry a pregnancy because of the side effects from chemotherapy and radiation treatments. Depending on the type of cancer, reproductive organs may be removed or damaged. Parenthood is still possible, however, regardless of the toll cancer treatments have taken. This is true even if you were not able to store eggs/sperm/embryos prior to treatment. Donor eggs/sperm/embryos are widely available and a fertility specialist is a great resource for learning more.
Cancer can rob patients of hope, happiness, time, and normalcy, but it doesn’t have to shatter your dreams of parenthood. Many cancer survivors turn to surrogacy when they can no longer carry or when it is no longer safe to become pregnant.
In surrogacy, a healthy woman will carry a pregnancy on your behalf. She will become pregnant using gametes from one or more parent or from a fully donated embryo. Under gestational surrogacy, the surrogate is not the mother to the child she carries; she becomes pregnant via an embryo implantation procedure. This is why gestational surrogacy is generally more popular than traditional surrogacy because parentage is inherently more complicated when the surrogate is the biological mother as is the case under traditional surrogacy. Both types of surrogacy can be great options for cancer patients, however.
If you’re a cancer survivor who cannot carry a pregnancy, the first step would be to find a gestational or traditional carrier. Some will find that family members or friends will step up and volunteer, others will need to find a surrogate via a surrogacy matching process. Surrogate agencies are a costly way to match, while independent journeys can be a preferred option for many. Surrogacy Place is a surrogacy self-matching website; cancer survivors are welcomed to create profiles and start finding potential matches.
Once you find your surrogate, you’ll need to have a Reproductive Endocrinologist examine her and provide his/her medical stamp of approval. Following medical clearance, lawyers representing you and the surrogate (the surrogate must have her own attorney that Intended Parents pay for) will finalize a surrogacy agreement. In the final agreement, the responsibilities of each party are codified, including the agreed-upon surrogacy compensation.
Surrogacy is incredibly expensive. Many Intended Parents will dip into savings or retirement accounts, or take out home equity or personal loans. For a sense of the typical costs, please see this surrogacy cost guide.
The regulations surrounded surrogacy vary widely across the US and the world. It’s important that you work with an experienced attorney. If you need help finding legal resources in the US, please visit our attorney directory page.
Do note that medical advancements and treatment options are constantly evolving. Always consult with a trusted reproductive medicine specialist to explore the available fertility options and what might be best for your specific situation.
Cancer survivors may find surrogacy to be an emotionally and financially draining process in unique ways. Many will want to seek support groups as they navigate their fertility and parenthood options. Organizations like Resolve and the National Association for Cancer Survivorship are on the front lines of advocating for cancer survivors. Others will turn to friends, family, and mental health professionals. You will need a community for support and there are people like you who have been through both cancer and infertility and understand the journey.
