Treatments and Services
Treatment & Services: Fertility Preservation
What is fertility preservation?
Some treatments for cancer and blood disorders can make it harder or impossible to get pregnant or to make someone pregnant later in life. Some patients can take steps before treatment to make it more likely to have biological children in the future. This is called “fertility preservation.” It is an important part of planning for life after cancer.
Seattle Children’s experts help by:
- Talking to you about your treatment and how it may affect your fertility
- Giving you educational materials designed for teens and young adults to help you understand all your choices
- Referring you to other experts at Seattle Children’s for treatment or to fertility preservation services in the Seattle area
How treatments for cancer or blood disorders affect your fertility depends on:
- Your age at the time of treatment
- The type of cancer or blood disorder you have
- The kind of chemotherapy drugs that you receive
- Where on your body you get radiation
- How much chemotherapy and radiation you receive
- How long it has been since treatment when you try to have a baby
What’s special about fertility preservation at Seattle Children’s?
We not only help you fight your disease – we do all we can to make sure you have a fulfilling life. You’ll get the care you need from specialists in our Urology and Gynecology programs and our Cancer and Blood Disorders Center.
For more than a decade, our Cancer Center has been consistently ranked among the top pediatric oncology programs in the country by U.S. News & World Report. For 2019-20, it has the highest ranking in the Northwest.
At Seattle Children’s, fertility preservation is a normal part of taking care of our patients. If treatment may harm your fertility, your doctor will talk with you and your family about it.
We will tell you about possible ways to preserve your fertility. If you are interested, we help you take the needed steps. This may include setting up an appointment with a sperm bank or a reproductive center that stores and freezes eggs.
We cannot be certain about who will have fertility problems after treatment and who will not. In addition, some patients may be too young to undergo most methods of fertility preservation. Others may not have time before their cancer treatment starts. As part of your long-term follow-up after treatment, your healthcare team will check your fertility and help you plan for the future. If fertility is a problem, we can help you think of other ways to start a family.
Our long-term research follows patients who have had chemotherapy or radiation even after they reach adulthood. This gives us a better understanding of long-term effects of treatment and ways to improve quality of life. We work with researchers at Fred Hutch and UW Medicine, our partners in Seattle Cancer Care Alliance (SCCA).
Dr. Margarett Shnorhavorian, a pediatric urologist and expert in fertility preservation, looks for new ways to preserve fertility. She is studying options such as saving testes tissue from boys who don’t make sperm yet. Boys are born with immature sperm cells (spermatagonial stem cells) that do not become sperm until a boy reaches puberty. The tissue is stored in the hope that one day it will be possible to make immature cells develop into sperm.
To better understand the effects of cancer treatment on girls, Seattle Children’s took part in a recent national study of female fertility over the course of treatment. Doctors measured chemicals in patients’ blood that indicate whether the ovaries are healthy.
Cancer Treatments and a Woman’s Fertility (13:14)
Cancer Treatments and a Man’s Fertility (10:54)
Options to Preserve Fertility
Freezing and storing some of your sperm is called sperm banking. This is an option for male patients who are physically and emotionally mature, starting at about age 12.
Usually sperm are collected by having a patient ejaculate into a container. If that is not possible, boys who are near puberty (peri-pubertal) may be eligible for a surgical option to get sperm. This is called testicular sperm extraction (TESE).
It is best to do sperm banking before treatment starts. There may be other times when this will also work. Talk to your healthcare team.
Only you can use your sperm sample. The sperm bank will talk to you about what will happen to your sperm if you don’t need it in the future.
Freezing eggs and storing them is an option for females who have started having periods (menstruation). This involves taking hormones to make your ovaries release eggs (ovulate) before you start treatment. Then, a minor procedure is done to remove your eggs.
The eggs can be frozen without being fertilized (ooctye cryopreservation). Or they can first be fertilized with sperm from your partner or a donor. Freezing fertilized eggs is called embryo cryopreservation.
The eggs or embryos can be stored for many years until you are ready to become a parent. If your unfertilized eggs have been stored, your partner’s sperm can be used to fertilize the eggs.
Preserving eggs takes at least 2 weeks to finish before you start treatment for your illness. This is how long it takes for the hormones to make you ovulate. Your cancer doctor can let you know if it is safe to delay your treatment. In some cases, egg collection can be done after you finish treatment or between different treatments.
A medicine called leuprolide acetate (Lupron Depot) is an option to help preserve fertility in girls and women who are getting certain chemotherapy medicines. Your provider can discuss this option with you.
It works by reducing activity in the ovaries while a patient undergoes chemotherapy. This may protect eggs in the ovaries and increase the likelihood of having normal menstrual periods after treatment ends.
Health insurance may not cover these procedures. Ask your health insurer what is covered and how much you will have to pay.
Financial help may be available from the clinic that is storing your sperm or eggs or from programs like LIVESTRONG.
To make an appointment, you can call us directly or get a referral from your primary care provider. We encourage you to coordinate with your family doctor when coming to Seattle Children’s.
Providers, see how to refer a patient.