Some more thoughts on the topic of fertility preservation raised by Dan in this thread.

It's important that if you have recently been diagnosed with a cancer problem, and you may wish to have one or more children in the future, that you inform your doctor and your medical team about your fertility needs, and if possible discuss fertility issues with your doctor and medical team before decisions are made about treatments for your cancer problem. Don't rely on them to bring the subject up - they may not do it as their first concern will be for your immediate health and safety.

Supporters can help by making sure fertility is on the list of items to be discussed, and perhaps even initiating a discussion if you're attending medical appointments.

There are two good reasons for discussing fertility matters before any treatment decisions are made. The first is that some treatments for cancers can lessen your fertility or even cause permanent infertility in some cases. But fortunately there are often different treatment options available so you and your medical team can choose treatments which maximise your chances of being fertile in the future. Treatments for many cancers can be delayed for a while until fertility issues have been addressed.

The second reason is that if you think your fertility is going to be impaired in the future either by the cancer itself or by the recommended treatments, you may want to consider the options of preserving embryos, or eggs, or sperm, or some other procedure that preserves reproductive cells or tissue for future use. Usually these procedures either need to be done or are best done before treatment starts.

The American Society of Clinical Oncology has recently published an important scientific paper called "American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer Patients" [the subject of the article Dan refers to above]. The paper is especially relevant to those who have been newly diagnosed with cancer who wish to retain their fertility, and for members of the medical profession who may be advising newly diagnosed patients on treatment regimes.

Here are some quotes from the paper:

"The purpose of this guideline is to review the literature pertaining to fertility preservation options for men, women, and children undergoing cancer treatment, and to give guidance to oncologists about these issues."

"RECOMMENDATIONS: As part of education and informed consent before cancer therapy, oncologists should address the possibility of infertility with patients treated during their reproductive years and be prepared to discuss possible fertility preservation options or refer appropriate and interested patients to reproductive specialists. Clinician judgment should be employed in the timing of raising this issue, but discussion at the earliest possible opportunity is encouraged. Sperm and embryo cryopreservation are considered standard practice and are widely available; other available fertility preservation methods should be considered investigational and be performed in centers with the necessary expertise."

"CONCLUSION: Fertility preservation is often possible in people undergoing treatment for cancer. To preserve the full range of options, fertility preservation approaches should be considered as early as possible during treatment planning."

The full text of the scientific paper can be found here http://www.jco.org/cgi/content/full/24/18/2917 and a patient-friendly "ASCO Patient Guide: Fertility Preservation" can be found here http://www.cancer.net/portal/site/patient/menuitem.169f5d85214941ccfd748f68ee37a01d/?vgnextoid=6a57ffdb060fa010VgnVCM100000ed730ad1RCRD

I suggest browsing through the scientific paper whether or not you read the patient-friendly guide, even if you don't understand some of it - that way you get the information straight from the people who reviewed the scientific literature and prepared the guidelines.

The above is mostly quoted from my webpage http://www.bestcancersites.com/fertility/ which I'm in the process of updating, where you can find _link_s to a variety of fertility-related websites.

For anyone who has low fertility either due directly to a cancer or due to cancer treatment, there are various options you can pursue. Reproductive technology has come a long way in recent years. Eg for men with extremely low viable sperm counts, I gather that individual viable sperm can be hunted down, captured, and injected into eggs (doubtless its not quite as simple as I've made it sound there).

And for anyone who has become infertile due to cancer and its treatment there may be options such as adoption to consider.

There will probably come a time when all general practitioners and other members of the medical profession who work at the front line of cancer diagnosis and treatment planning, have fertility needs on their checklist of topics to discuss at an early stage of consultations. From what I read, we are a long way from being there yet.

Maybe "regulars" (a word which always reminds me of people leaning on a bar at the local pub) on these forums could keep an eye out for new members posting for the first time who've recently been diagnosed, and suggest they put fertility on their list of items to discuss with relevant member(s) of their medical team.
Cheers,
Ed Everest.

Hi Ed Everest. Just a quick note, I checked out your website and I noticed you mentioned this site as www.teamrevive.org - it is actually accessed by www.teamrevive.com (even though it is a .org site - I know, don't ask...). www.teamrevive.org will not access this site.
Cheers, Anto.

Thanks Anto - I think that problem may have been fixed - on both my explorer and firefox browsers org works and so does com. The com switches automatically to org in the adress window which probably means that the com domain name has successfully been redirected by the com domain owner to the org domain. Maybe you'd like to give it another check and let me know what happens (making sure your computer is not loading a cached version) .

Hi Blue sky

You have written some good info on fertility. Just wondering about adoption for cancer survivors. Do the adoption agencies put them way down the list?

Thanks

Hematite

That is a very good question Hematite and one I don't know the answer to .

There's a short and useful discussion on the topic on the US-_base_d breastcancer.org website here
http://www.breastcancer.org/tips/fert_preg_adopt/adoption.jsp

On the US-_base_d http://www.fertilehope.org website they say:
"Most adoption agencies report that they do not rule out cancer survivors as potential parents, especially with documentation from a doctor stating that lifespan and quality of life are expected to be good. However, some agencies do require a certain amount of time to pass before allowing a survivor to be eligible (e.g. 5 years). The adoption process takes time (6 months to 2 or 3 years) and costs vary greatly, from $2,500 - $35,000".

I suggest spending some quiet time searching away on the internet for more information and for posts from people who've been diagnosed with cancer reporting their own experiences of applying to adopt. If I find any other _link_s to good discussions on the topic I'll post them here.
Good luck!
Ed.

Hello, I thought this information regarding Intercountry adoption may be useful.
The intercountry adoption process used in each State and Territory is similar, but not identical. Legislation in each State and Territory governs intercountry adoption matters. Differences in process and requirements may also occur in each overseas country that Australia has a program with. You should contact your State or Territory authority for specific process information.

The website below is very helpful and information kits can be downloaded from each state. I do know the information kit for Victoria for example, includes detailed eligibility criteria. A country such as China specifically states "no severe form of cancer, including Leukaemia" however couples must meet extensive health criteria. There are a number of other countries that do not go into such detail, so it would definately be worth contacting your state agency to discuss eligibility.

http://www.ag.gov.au/www/agd/agd.nsf/page/Intercountry_Adoption

Cheers Anita

Thanks Anita for this info. You'd think people would want to help long term cancer survivors adopt because they've had such a bad thing happen! Becoming infertile wasn't our fault - the doctors stuffed up!

WOW,
What I have just read was pretty intense. When my daughter (21) was diagnosed 8 weeks ago, she was living in QLD. Diagnosed Wednesday, started Chemo Thursday. I arrived up there on the Thurs night from Sydney. Nothing was mentioned to Carly about infertility or the risks and it was not until I read something in one of the books that they gave me that I realised she could be infertile from not only the chemo but deffinatley from the bone marrow transplant she has to have. We have had to tell her the truth which has thrown her as whilst she hasn't really thought about kids the choice was always there.

Carly has asked the doctors if she can have eggs perserved before she has the transplant and the doctor was quite vague but did say to her that should be fine. I personally think he is lying to her as she now thinks that she can definatly store some eggs before her transplant.

I think it is sad for the young ones who have to start chemo immediatly and don't really get the chance to let anything sink in including fertility preservation.


Cheers

JOJO

Jojo hi,

I agree with you - it is sad .

A couple of questions for you. Is your daughter currently on chemotherapy? And have you red anything or been told anything about what are the chances of her fertility returning after the bone marrow transplant?

If there's a substantial risk of her fertility never returning after the transplant, then in my personal opinion she and you should consider doing whatever you can to preserve her fertility by whatever means you can, before the transplant.

If eggs that may be fertile can be preserved, then that may be the way to go. As I understand it, preserving embryos is more reliable, so you may consider investigating that option too, although I'm not sure whether that would be an available option in your daughter's case unless she has a partner.

I think you should consider getting outside professional advice from a fertility expert about your daughter's situation, if there's no suitable expert in the hospital to advise she and you.

Cheers,
Ed.