Advances in oncofertility are giving today’s cancer patients a better chance at parenthood
For years, a cancer diagnosis often meant the end of fertility. The most common treatments for cancer, including chemotherapy and radiation, carry a high risk of impacting the ability to release eggs and degrading the quality of eggs. Primary ovarian insufficiency has many medical causes, but oncology treatment is one of the top factors.(1)
“The oncofertility movement kicked off in October 2001 with the launch of Fertile Hope and it’s been a critical area of focus in both oncology and reproductive medicine ever since,” says Lindsay Beck, a two-time cancer survivor who used ART to conceive successfully. As a board member of the Alliance of Fertility Preservation, Beck says future fertility is a top concern for most young adult cancer patients. Thanks to advances in medicine, and the companies working to bring those advances to patients, Beck says this concern is often solvable.
“Collaboration between oncologists and reproductive specialists in ensuring patients receive timely and effective oncofertility care is critical. They may collaborate on a variety of things, including treatment protocols and timelines,” Beck says. “For example, an oncologist may want to sign off on the safety of certain fertility medications for a patient and the physicians may want to coordinate schedules so that the patient undergoes fertility preservation treatments in between cancer surgery and the start of chemotherapy.”
Barriers — and solutions — to preserving fertility
While improvements in reproductive technology and oncofertility give many patients hope for a family, some barriers remain, according to Keith Gordon Ph.D., Executive Director of Medical Affairs and Fertility Lead at Organon. “It’s still uncertain. Even if you freeze 20 eggs, they may not fertilize and you may not be able to conceive afterwards,” he says. “It’s just improving your chances.” Organon is committed to helping aspiring parents on their fertility journey through elevating education and awareness, expanding resources and access to care and investing in innovative fertility solutions.
From a possibility to an increased probability
Dr. Gordon cites the success of IVF overall as a win for oncofertility patients and says the chances of starting a family after cancer are higher than ever before. “I’ve been in this business for about 30 years, which was close to when it started.” He recalls a time when doctors regularly implanted multiple embryos in hopes that just one would result in pregnancy. Now, preimplantation genetic diagnosis allows doctors to select embryos most likely to result in a live birth.(2) “If you transfer a single, good quality blastocyst, some centers are having success upwards of 60% or 70% of those implants.”
More states expected to introduce fertility preservation legislation in 2025
Cost is a barrier for many patients, as the price tag of cryostorage and future rounds of IVF may be prohibitive for some. “There are clinics that offer discounts to patients who are diagnosed with cancer to help with egg freezing as well as medication discount programs from the drug manufacturers,” says Dr. Ravi Gada a reproductive endocrinologist and fertility specialist at DFW Fertility Associates in Texas. Dr. Gada is also the Medical Director of ReUniteRX, a program that provides discounts to eligible patients on fertility medications, including those manufactured by Organon. Programs like this can help oncofertility patients.
Currently, 18 states as well as the District of Columbia require insurance to cover some costs associated with fertility preservation for patients with medically-caused infertility. Beck adds that the Veterans Health Administration and Federal Employees Health Plan have now established this benefit, and says advocates for oncofertility expect a number of states to introduce fertility preservation legislation in 2025.
Critical timing
The final barrier to preserving fertility is timely information, says Dr. Gada. Patients need to be aware of fertility preservation options when faced with a cancer diagnosis, as many will have to make decisions quickly. “There is a limited amount of time that patients have to undergo fertility preservation procedures before they must start their cancer treatments, specifically chemotherapy.” Oncology teams need to work closely with fertility specialists following a cancer diagnosis.
From hope to meaningful strategy
The positive effects of fertility preservation on cancer outcomes offer hope. Beck points to research by Catherine Benedict at Stanford, which shows just how crucial that hope is to patient outcomes. “Cancer diagnoses are on the rise in young adults, and survivorship rates are high,” says Beck. “At the same time, fertility preservation options are more prevalent and more successful than ever before.”
1 Gurgan T, Salman C, Demirol A. Pregnancy and assisted reproduction techniques in men and women after cancer treatment. Placenta. 2008;29 Suppl B:152-159.doi:10.1016/j.placenta.2008.07.007
2 Kanaka V, Proikakis S, Drakakis P, Loutradis D, Tsangaris GT. Implementing a preimplantation proteomic approach to advance assisted reproduction technologies in the framework of predictive, preventive, and personalized medicine. EPMA J. 2022;13(2):237-260. doi:10.1007/s13167-022-00282-5
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