60 SIDE EFFECTS AND SYMPTOM MANAGEMENT /// CHAPTER 40 How do I know how if I am at risk for future infertility? Several studies have been done focusing on the fertility of cancer survivors receiving different types of treatment. This has helped doctors better understand how treatments affect fertility. Future infertility risk ranges from low risk to high risk. You will receive a fertility risk assessment before treatment begins and any time your plan changes. Your risk assessment looks at: » Type and doses of chemotherapy you will receive » Dose and area of radiation planned » Surgery to your reproductive organs Any risk assessment is an estimate, not a definitive statement of what will happen to you. As we continue to learn more about the impact of treatment on fertility, your risk assessment could change. Embryo Banking Ovarian Suppression What can I do to protect my future fertility if I am at risk? Fertility Preservation: If treatment reduces your fertility, before treatment begins, there are ways to save your oocytes or follicles for future use. The fertility preservation methods we can offer will depend on your age, the type of treatment you will receive, and if you will need to begin treatment immediately. It is your choice to participate in fertility preservation. Fertility Preservation Methods: After Puberty Oocyte Banking Hormone shots are given for several days. Oocytes are then collected using a needle inserted through the vagina and into the ovary. These oocytes are frozen and stored for future use. After collecting oocytes, a partner's sperm fertilizes the oocytes. This forms an embryo that is frozen and stored for future use. A shot is given to stop the hormone communication between the brain and the ovaries. This reduces the activity of the ovaries and may protect follicles from chemotherapy-related damage. Periods will stop during this treatment. Before & After Puberty Ovarian Shielding Oophoropexy During radiation to or near the ovaries, a lead shield is placed over the lower pelvis to protect the ovaries from the radiation. A small surgery to protect the ovaries by moving them away from the area that will receive radiation. They are moved back to their normal location after treatment ends. Ovarian Tissue Cryopreservation One ovary containing immature follicles is removed and frozen. While there have been some healthy births using this method, it is still in the early stages of use. Note: This method of fertility preservation is for those at highest risk of infertility because it involves a surgery and removal of one ovary. https://www.savemyfertility.org/pocket-guides/patients/fertility-preservation-women-diagnosed-cancer RESOURCES https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-andsexual-side-effects/fertility-and-women-with-cancer/how-cancer-treatments-affect-fertility.htmlhttps://www.savemyfertility.org/pocket-guides/patients/fertility-preservation-women-diagnosed-cancer https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/fertility-and-women-with-cancer/how-cancer-treatments-affect-fertility.html https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/fertility-and-women-with-cancer/how-cancer-treatments-affect-fertility.html https://fwaya.org/