With more people surviving cancer, preserving a patient’s fertility so they can become a parent is more important than ever.
But how best to do that is not always clear because there is no reliable evidence about which cancer treatments are most likely to make patients infertile.
Now Australian doctors at Sydney’s Prince of Wales Hospital are establishing a world-first cancer register to capture a patient’s fertility journey from diagnosis to survivorship.
The aim of the site www.futurefertility.com.au is to collect data to help doctors and patients make better decisions about cancer and fertility.
At present patients have to make decisions about whether to freeze their eggs, sperm or embryos when they are also dealing with a cancer diagnosis.
Not all cancers or treatments, such as chemotherapy, render patients infertile. And there is little definitive data to guide doctors and patients on the best course of action.
Developing best practice for fertility management
Professor Bill Ledger, head of obstetrics and gynaecology at the University of New South Wales, said this was the first attempt to collect information on a national scale.
“We will follow people long-term so doctors know exactly what works and what doesn’t,” he said.
“We will know – for different age groups, different cancer and different treatments – who needs to freeze their eggs and who doesn’t, and how likely they are to have a child down the track.”
Leading the project is Dr Antoinette Anazodo, a child and adolescent cancer specialist at the Prince of Wales Hospital.
“Eighty per cent of cancer patients become survivors and the number one thing that worries them most at one and five years [post-treatment] is infertility,” she said.
One of the aims of the group is to help doctors develop best practice guidelines for addressing fertility issues in cancer patients.
The team has already set up the first charter for oncofertility, with significant input from adolescent, young adult and adult cancer patients.
Making difficult decisions
At just 22, Amy Weiss had to cope not only with a diagnosis of Hodgkin’s lymphoma but also with deciding if she wanted to protect her fertility before starting treatment.
“All of a sudden, I had to think about how many kids I wanted to have,” she said.
“It was very overwhelming. It was a lot to think about on top of everything else.”
Before having chemotherapy, Amy chose to freeze her eggs.
Now in remission, she is very happy with her decision.
“It was a relief to know I could live my life and if I needed them [her eggs] they were there,” she said.
“It worked out well in the end.”