Fertility Options for Young Female Cancer Patients

Chemotherapy and other cancer treatments can cause infertility. The Children's Hospital of Philadelphia has one of the best fertility preservation programs in pediatric oncology, offering choices for teenagers and young women as well as girls who have not yet experienced puberty. Options include egg harvesting and ovarian tissue cryopreservation. Learn about fertility preservation for young women and girls treated for cancer at one of the world's leading pediatric hospitals. 

Transcript

Fertility Options for Young Female Patients

Rachel: She hadn't learned yet about how we have eggs in our body.

Hannah: Well we, we just learned about that.

Rachel: Yeah.

Hannah: In health class right now.

Rachel: And she's ten now, so they're learning about that in health class now. But she didn't know, so I had to have a conversation with her about…

Hannah: It was a small conversation, it wasn't really that long.

Rachel: I explained to her that every girl has eggs in their body and that these eggs eventually can become babies, and that her treatment can make it so that those eggs are no longer able to work. And so what they were going to do was take a piece of the organ that has the eggs in it and save it for her so that one day she could use them.

Hannah: It was kind of a little confusing, but, I went with it. And it feels good. And feels right somehow. But…

Jill Ginsburg, MD: We're curing more and more kids of their cancer every year. And they are surviving well into their reproductive years. Having to tell a survivor that they're infertile is probably the hardest discussion I have. And so our goal through this program is to have that discussion less and less frequently in the future by sort of intervening as early as we can to try and preserve a patient's fertility so that when they enter survivorship we have only good news to tell them.

Katie: I think that the conversation about whether or not you want to preserve your fertility is very necessary. I would say that you always need to look forward to something in the future when you have cancer.

Clarisa Gracia, MD: One of the most important factors in a patient's quality of life is the ability to have reproductive options and to have biological children. And so this has become a major quality of life issue for cancer survivors. I think it's very important that there are programs available for children and their families to pursue fertility preservation, to really give them hope for the future, and options to improve their quality of life.

Farah: The doctor was really straightforward in our conversation about fertility like preservation. And she told me what to expect and that it doesn't always work, but there's like a hope that it does. And also she was very straightforward. She didn't sugarcoat anything which I appreciate.

Sue Ogle, MSN: Probably one of the greatest things that we've learned from talking with our patients and families over the years is that no matter how uncomfortable this is, no matter what our worries, concerns, thoughts are, the patients want to talk about this.

Christine: When you have cancer and you're receiving chemotherapy, it may seem like a lot and it may seem like a pain to do something additional with getting the egg retrieval or the ovarian tissue surgery, but once we made the decision, my doctors were very supportive and informative. And it was really clear. I think it just came to the point where whether I decided I wanted it. And after that the ball was just rolling. And it wasn't that hard to like figure out what we needed to do.

Rebecca: This was definitely very scary to think that here was my future in front of me and what, what do I do with all this information? But it kind of solidified what I want in my life. And just made me really think on a deeper level than maybe I would have liked to. But yeah it was important.

Sue Ogle: Even though they want first diagnosis and they want cure, they also want to know that their children will have the ability to have children if they so desire later on down the road.

We need to continue talking about it as it’s a piece of who our patients are and who they will become as they move through the world of patient, survivor, and hopefully adult and possibly mother.

Jill Ginsburg: There are really two options. One is egg freezing, where the patient is given medicines to sort of stimulate the production of their eggs. And then under general anesthesia those eggs are retrieved and frozen away. In cases where we don't have the luxury of time, we can do ovarian tissue preservation where under general anesthesia in the operating room, a laparoscopic biopsy of the ovary is done, and a small piece of ovarian tissue is removed and frozen away for the patient.

Christine: I think it was definitely a wise decision to be part of this program, because although when I was 16 I hadn't expected to be in ovarian failure, now that I'm 21 and I am currently in ovarian failure, to have the option to have eggs in the bank is really reassuring. But I think afterwards when everything is said and done, I would have really regretted it if I didn't do it.

Sandi: We've always spoken open and honestly, and I think we were both on the same page that given her heart desires to eventually have a family, that if there was something that modern day technology and research was allowing for, it was beneficial to, to go for that.

Rebecca: So I am really happy that I did it because now I don't have to worry about, well you know, I'm like 20 and maybe I won't be able to have kids. Now I can push it out of my way and think about things like finishing college, and dating and just things that normal 20 year olds have to think about and not something out of the ordinary.

Rachel: When she was in treatment, you can't help but think about her future. And you can't help but think about is she going to make it? Is she going to make it to be married? Is she going to make it to have kids? Is she going to make it to make me a grandmother? But now I think I've gotten to the point where she's going to have kids. I'm going to be a grandmother.

Hannah: You might want to have kids when you're older. You might not have a chance to do it. And this is a good opportunity to do it.

Ghazala: This is something that brings positivity to this whole negative situation and then to be honest with your child, because you know even though they seem young, they are capable of making the decisions.

Farah: This fertility treatment it's definitely important for cancer patients. I mean like especially for pediatric patients too because like they have their whole life ahead of them and you need that choice too. I think everyone should have like a choice of being a mom. I think that's very important to give them that choice, because everyone else has the choice, and we shouldn't be left without it.

Jill Ginsburg: Fertility preservation here at CHOP is really the first comprehensive program in a pediatric hospital. It’s the most comprehensive and we offer the most options to our patients and their families. We also have served as a model to other institutions.

Sue Ogle: I think girls grow up thinking about being mothers at an earlier age. I think our society does that. I think that fertility preservation, the thought of being a parent later on is equally as important, we've learned, to boys and girls.

Rachel: What are your hopes for the future?

Hannah: Finish school, go to college, get married, well find a boyfriend, then get married, um, have kids, and then have grandkids, and hopefully go to heaven. 

Topics Covered: Fertility Preservation Program

Related Centers and Programs: Childhood Cancer Survivorship Program