Options for Cis Females and Trans Males
Egg freezing allows individuals, both cis women and trans males, who require cancer treatment to freeze their eggs for later use. Cancer therapies such as chemotherapy, radiation, and surgery can impact a patient’s ovarian reserve and, in some cases, can cause premature menopause post treatment. Egg freezing is a way to preserve fertility. The patient will undergo ovarian stimulation, which is started by administering daily injections of FSH and hMG for 9–12 days. When instructed, a trigger shot is given to mature the eggs and 36 hours later a minor surgical procedure, called an egg retrieval, is performed under anesthesia. All mature eggs are frozen and stored for future use. When the patient is ready for parenthood, the eggs are thawed, fertilized and biopsied for genetic testing (if desired) and transferred to the uterus. The egg freezing process typically lasts two weeks. The patient’s fertility doctor will discuss the proposed treatment and timeline with their oncologist to ensure that the timing is appropriate. Patients should let their cancer care team know that fertility preservation is important to them.
At Progyny, we know that when you are faced with a cancer diagnosis, future family building may not be top of mind. Due to earlier detection and improved treatments, survival rates among reproductive age patients diagnosed with cancer have steadily increased over the past four decades. As a result, focus has shifted from immediate treatment to life after cancer too, including future family building. Since many cancer treatments can impact your future fertility, it’s important to explore your options.
Options for Cis Males and Trans Females
Sperm cryopreservation is offered to patients, both cis males and trans females who are post puberty, prior to starting cancer treatment. It enables them to preserve healthy sperm to use at a later time for family building. For sperm cryopreservation, as many sperm samples as time permits are collected and a semen analysis is completed on each. The sperm samples are frozen and stored at a sperm bank for future use. When the time is right, the sperm is thawed and can be used for IUI or IVF with a partner or gestational carrier (surrogate).
In going through the fertility preservation experience, I felt that everyone was believing that I could survive.
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Patient Stories
A cancer diagnosis can be a scary and isolating experience but remember—you’re not alone. Sometimes it can be comforting to hear stories of those who have been on a similar journey. We’ve compiled some inspiring stories of fertility in the face of cancer on our podcast, This is Infertility.
Support for Your Journey
There’s no right or wrong decision when it comes to fertility preservation, the most important thing is having the information at your fingertips so that at some point, as a cancer patient, you have a little bit of control while making a decision.
Kristin Smith
Oncofertility Consortium
Cancer itself may directly affect the reproductive system, such as cancer of the ovaries, uterus, cervix, or testes.
Cancer treatment, including chemotherapy, radiation, and surgery, can damage the reproductive system too. Some treatments, like certain chemotherapies and radiation, are gonadotoxic, meaning they will destroy sperm and eggs and therefore cause infertility; these effects can be temporary or permanent. Treatments like surgery and radiation can cause mechanical damage to the reproductive system through the removal of reproductive organs or damage their ability to function.
Frequently Asked Questions
To learn more about oncofertility treatment, call your PCA or 888.597.5065
Egg Freezing (oocyte cryopreservation)
Fighting for Fertility Preservation Changes
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Fertility Preservation Treatment Options
Patient Stories
Embryo freezing allows patients to create and freeze embryos for transfer at a later date. Although similar to egg freezing, we have more information about the future success rates with embryos since they are further along in the process, so freezing embryos is typically recommended for those already partnered or who have a sperm donor picked out. Eggs remain the property of the patient and they alone decide what will be done with them in the future. Embryos created with a partner’s sperm mean that both partners have to agree on their disposition (to attempt pregnancy, discard, etc.). Speak to your doctor to see if both egg and embryo freezing is an option for you.
Embryo freezing starts with ovarian stimulation by administering injections daily of FSH and hMG for 9–12 days. When instructed, a trigger shot is given to mature the eggs and 36 hours later a minor surgical procedure, called an egg retrieval, is performed under anesthesia. All mature eggs are fertilized using a semen sample from their significant other or a sperm donor. The embryos are observed in the embryology lab for 5–6 days. Then, viable embryos are biopsied for genetic testing (if desired) and frozen and stored for future use. At a later date, a frozen embryo can be thawed and transferred to the uterus. The patient’s fertility doctor will discuss the proposed treatment and timeline with their oncologist to ensure that the timing is appropriate. Patients should let their cancer care team know that fertility preservation is important to them.
Embryo Freezing
Ovarian suppression is used when patients cannot or choose not to freeze eggs or embryos. Instead, physicians will focus on protecting the ovaries during treatment. This will stop ovaries from ovulating temporarily, which decreases the blood flow to them and protects the eggs, ultimately minimizing potential chemotherapy damage. Ovaries are suppressed with a GnRH agonist like Leuprolide or Goserelin injections, which are given either monthly or every three months. When recommended, ovarian suppression is often initiated two to four weeks prior to beginning the first chemotherapy treatment and continued throughout the duration of treatment.
Ovarian Suppression
Ovarian shielding is used when patients undergo radiation therapy. A protective cover is placed over the outside of the body during treatment—specifically the ovaries—in order to protect the ovaries and minimize damage from the radiation. This may be covered through medical insurance. Please speak to your PCA about available options.
Ovarian Shielding
Ovarian transposition is a surgical procedure where a patient’s ovaries are repositioned outside of the pelvic radiation treatment field to reduce exposure and minimize damage. This is performed in patients with treatment that includes pelvic radiotherapy for Hodgkin’s disease and other gynecologic malignancies. Ovarian transposition may be covered through medical insurance. Please speak to your PCA about available options.
Ovarian Tissue Freezing
Ovarian tissue freezing is used in some circumstances where patients are unable to undergo ovarian stimulation for egg or embryo freezing, and the only viable option is to surgically remove and preserve ovarian tissue. One whole ovary (or parts of the ovary) are removed. The tissue that contains the eggs is separated from the rest of the ovary, frozen, and stored for future family building. If the patient is no longer fertile after cancer treatment, using this tissue may help the patient have a biological child. It is usually used by female patients who do not have adequate time for egg or embryo freezing and pre-pubertal females who are not able to undergo ovarian stimulation. Ovarian tissue freezing is not covered by the Progyny benefit. Please speak to your PCA about available options.
Ovarian Transposition
Sperm Cyropreservation
Testicular tissue freezing, which is still considered an experimental procedure, may offer prepubertal boys who are not producing sperm the opportunity to preserve their fertility. It requires a surgical procedure to obtain a biopsy of the teste (tissue), which is then frozen and stored at a tissue bank for use if desired. Although it is still an experimental procedure, as science and technology improve specialists are studying ways to form sperm from the tissue that’s removed. Testicular tissue freezing is not covered through the Progyny benefit. Please speak to your PCA about available options.
Testicular Tissue Freezing
Let your cancer care team know that fertility preservation and future family building is important to you. Search for an in-network Progyny provider and reach out to your PCA who can help you schedule an appointment. Your PCA can assist you with getting an expedited appointment with a reproductive endocrinologist to learn more about your options.
How does cancer treatment affect my fertility?
Your PCA can assist with finding other resources you may have available to you through your employer. Examples of other resources are mental health support, cancer care support, second opinions, and many others. At Progyny our goal is to ensure you are armed with all of the resources you have available to you.
What should I do first?
Speak to your PCA about your coverage for egg freezing, sperm freezing, and embryo freezing. Coverage varies, and your PCA can explain your benefit in detail, including your financial responsibility.
Do I have coverage?
Egg and embryo freezing takes about two weeks to complete. Sperm cryopreservation takes about one week to collect two specimens with 48–72 hours in between.
How long does the fertility preservation process take?
In many cases, there is enough time after a diagnosis and before treatment starts to complete the fertility preservation process. It’s important to note that your fertility team will consult your cancer care team to ensure that your fertility preservation does not interfere with your life saving cancer treatment.
Is it safe for me to delay treatment to preserve my fertility?
Yes, you may still have options! You should speak with a reproductive endocrinologist to discuss fertility testing and fertility preservation options.
I already started treatment; can I still preserve my fertility?
You may still have the option of using your own eggs or sperm to create a family. Start by speaking to your PCA about scheduling an initial consultation and diagnostic testing appointment with a fertility doctor who can discuss your options. Adoption and third-party reproduction, including egg and sperm donation or surrogacy, are options for you if you cannot conceive using your own eggs or sperm. Egg and sperm donors may be anonymous, or a friend or relative. Gestational surrogacy is another option if pregnancy is not possible. If you would like to receive more information about adoption, egg or sperm donation, and surrogacy, please contact your PCA.
I am a cancer survivor and did not preserve my fertility. What are my family building options?
What are my other resources through my employer?
The Hope Fertility Preservation Can Bring
Helping Patients Navigate Between Oncology and Fertility
Donor Eggs, Surrogacy, and Embracing a New Plan
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We’ve compiled these resources so you know why it may be important to preserve your fertility and what to consider as you begin the journey.
Your dedicated Progyny Patient Care Advocate (PCA) is here to support you and to help you navigate the process. If you ever feel overwhelmed, please don’t hesitate to reach out. And, if your friend or loved one is diagnosed with cancer, please share these resources with them.
Oncofertility Resources
Your Future Family:
Fertility Preservation Treatment Options
Making Fertility Preservation a Priority
Episode from the podcast
28m 44s
Listen:
34m 20s
33m 42s
22m 41s
31m 47s
Don’t underestimate the value of a good support system on your cancer journey. In the aftermath of a diagnosis and throughout your treatment journey, a solid support system can leave you with a sense of normalcy and emotional stability, which can be important for your recovery. Surrounding yourself with friends and loved ones and having the support from dedicated cancer resources can be comforting.
Your Progyny Patient Care Advocate (PCA) is always available to provide ongoing emotional support throughout your fertility preservation journey. Whether you’d like help setting up appointments, or you just need someone to talk to, your PCA is here for you.
Imerman’s Angels provides free one-on-one support to previvors, patients, survivors, and caregivers. Patients are matched with a survivor who has survived the same type of cancer.
4th Angel provides one-on-one support with a trained volunteer mentor through online chat, phone, or email.
Livestrong provides one-on-one guidance to assist women, men, and the parents of children diagnosed with cancer at any time during their cancer diagnosis.
Cancer Care offers counseling, case management, and support groups for those with cancer as well as their caregivers. Educational resources and financial assistance are also offered through their many programs.
Joyce Reinecke
Alliance for Fertility Preservation Executive Director, and cancer survivor
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Covered
by the Progyny benefit
Progyny.com/education has many resources on covered treatment types. Our curated library of educational material includes podcasts, videos, infographics, and articles.
Triage Cancer is a national, nonprofit organization that provides education on the practical and legal issues that may impact individuals diagnosed with cancer and their caregivers.
Alliance for Fertility Preservation is a non-proft organization focused on increasing information, resources, and access to fertility preservation for cancer patients and the healthcare professionals who treat them.
Oncofertility Consortium represents a nationwide, interdisciplinary, and interprofessional network of medical specialists, scientists, and scholars who are exploring the relationships between health, disease, survivorship, and fertility preservation in young cancer patients.
SaveMyFertility shares information and guidance on fertility preservation for adults diagnosed with cancer and for the parents of children who have been diagnosed with cancer.
31m 00s
Having a Fertility Benefit that Covers Fertility Preservation
Support for Your Journey
Frequently Asked Questions
Oncofertility
Oncofertility
Support for Your Journey
Frequently Asked Questions
Embryo Freezing
Embryo freezing allows patients to create and freeze embryos for transfer at a later date. Although similar to egg freezing, we have more information about the future success rates with embryos since they are further along in the process, so freezing embryos is typically recommended for those already partnered or who have a sperm donor picked out. Eggs remain the property of the patient and they alone decide what will be done with them in the future. Embryos created with a partner’s sperm mean that both partners have to agree on their disposition (to attempt pregnancy, discard, etc.). Speak to your doctor to see if both egg and embryo freezing is an option for you.
Embryo freezing starts with ovarian stimulation by administering injections daily of FSH and hMG for 9–12 days. When instructed, a trigger shot is given to mature the eggs and 36 hours later a minor surgical procedure, called an egg retrieval, is performed under anesthesia. All mature eggs are fertilized using a semen sample from their significant other or a sperm donor. The embryos are observed in the embryology lab for 5–6 days. Then, viable embryos are biopsied for genetic testing (if desired) and frozen and stored for future use. At a later date, a frozen embryo can be thawed and transferred to the uterus. The patient’s fertility doctor will discuss the proposed treatment and timeline with their oncologist to ensure that the timing is appropriate. Patients should let their cancer care team know that fertility preservation is important to them.
Ovarian Suppression
Ovarian suppression is used when patients cannot or choose not to freeze eggs or embryos. Instead, physicians will focus on protecting the ovaries during treatment. This will stop ovaries from ovulating temporarily, which decreases the blood flow to them and protects the eggs, ultimately minimizing potential chemotherapy damage. Ovaries are suppressed with a GnRH agonist like Leuprolide or Goserelin injections, which are given either monthly or every three months. When recommended, ovarian suppression is often initiated two to four weeks prior to beginning the first chemotherapy treatment and continued throughout the duration of treatment.
Sperm Cyropreservation
Ovarian transposition is a surgical procedure where a patient’s ovaries are repositioned outside of the pelvic radiation treatment field to reduce exposure and minimize damage. This is performed in patients with treatment that includes pelvic radiotherapy for Hodgkin’s disease and other gynecologic malignancies. Ovarian transposition may be covered through medical insurance. Please speak to your PCA about available options.
Sperm Cyropreservation