Fertility support

Some types of chemotherapy and radiotherapy may cause a temporary or permanent reduction in your fertility. It is very important that you discuss any questions or concerns you might have regarding your future fertility with your doctor if possible before you commence treatment.

In women, some types of chemotherapy and radiotherapy can cause varying degrees of damage to the normal functioning of the ovaries. In some cases this leads to menopause (change of life) earlier than expected. In men, sperm production can be impaired for a while but the production of new sperm may become normal again in the future. There are some options for preserving your fertility, if necessary, while you are having treatment for leukaemia. These are described below.

Protecting your fertility – men

Sperm banking is a relatively simple procedure whereby the man donates semen, which is then stored at a very low temperature (cryopreserved), with the intention of using it to achieve a pregnancy in the future. You should discuss sperm banking with your doctor before starting any treatment that might impact on your fertility. In some cases however, people are not suitable for sperm banking when they are first diagnosed because they are too ill and therefore unable to produce the sperm in sufficient quantity or quality.

If possible, semen should be donated on more than one occasion. It is important to realise that there are many factors that can affect the quality and quantity of sperm collected in a semen donation and its viability after it is thawed out. There is no guarantee that you and your partner will be able to achieve a pregnancy and healthy newborn in the future. You should raise any concerns you have with your doctor who can best advise you on your fertility options.

Protecting your fertility – women

There are several approaches that may be used to protect a woman’s fertility.

• Embryo storage – this involves collecting your eggs, usually after having drugs to stimulate your ovaries to produce a number of eggs, so that more than one egg can be collected. This process takes some time. Once they are collected they are then fertilised with your partner’s sperm and stored to be used at a later date. Your unfertilised eggs can also be collected and stored in a similar manner (egg storage).
• Ovarian tissue storage – this is still a fairly new approach to protecting your fertility. It involves the removal and storage, at a very low temperature of some ovarian tissue (cryopreservation). It is hoped that at a later date the eggs contained in this tissue can be matured, fertilised and used to achieve a pregnancy.

To date, egg storage and ovarian tissue storage are techniques, which remain under investigation. They have not yet been proven to be successful in allowing women to bear children. The use of donor eggs might be another option for you and your partner. These eggs could be fertilised using your partner’s sperm and used in an attempt to achieve a pregnancy in the future.

It is important to understand that the methods are still quite experimental and for many reasons achieving a pregnancy and subsequently a baby is not guaranteed by using any of them. Some are time consuming and costly while others may simply not be acceptable to you or your partner. In addition, because of the need to start treatment without delay and the problems associated with the leukaemia itself it is often not possible to collect eggs or ovarian tissue prior to the first cycle of chemotherapy.