Our new clinic aims to make fertility preservation a standard of care for patients of reproductive age.
For years, the issues of fertility, sexual dysfunction and cancer were never fully addressed. For many patients, having cancer meant that they might be unable to conceive later in life. A new program at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) hopes to make fertility preservation a priority and part of the initial treatment conversation.
Fear of delaying treatment has been one of the biggest obstacles.
“There was a bias with doctors (and patients) in believing there wasn’t enough time to begin fertility preservation prior to treatment,” said Leslie Appiah, MD, director of the Fertility Preservation and Reproductive Health Program at the OSUCCC – James. “But we now have random start protocols, in which eggs can be stimulated and extracted at any time during a woman’s menstrual cycle. It’s very important that women get the appropriate information about freezing eggs. It’s very safe and effective.”
Mandating Fertility Preservation as a Priority
In 2006, the American Society of Clinical Oncology created guidelines for fertility care during cancer treatment in people of reproductive age, mandating that they be counseled prior to treatment and that they be provided options throughout their treatment and during survivorship. However, studies in 2012 still showed that less than 50 percent of patients recalled having a conversation with their doctors about reproduction, and even less went on to pursue treatment, Appiah said.
More and more, cancer patients of reproductive age are being made aware of their options when it comes to fertility preservation, and more viable options are emerging to help. The initiative is called oncofertility, and it brings together the disciplines of oncology and reproductive research to address quality-of-life issues and reproductive concerns of young cancer patients.
For women with breast cancer and some blood cancers, this is particularly good news, as chemotherapy and radiation can drastically reduce her ability to conceive depending on age, treatment plan and baseline fertility. Advances in assisted reproduction therapy allow women to preserve their oocytes (eggs) before cancer treatments begin, Appiah said.
Although more patients are being counseled today, the number who undergo fertility preservation is still less than a third because the procedures can be cost prohibitive since they are not recognized as a standard of care and are therefore not covered by most insurances, Appiah continued.
“Only five states have insurance mandates to cover fertility preservation in patients with cancer, and Ohio is not yet one of them,” Appiah said. But, she added, discussions among medical and insurance industry experts are underway with legislators to bring it to the table.
|Read on: Cancer Survivors Have More Fertility Protection Options|