Your fertility may be affected by surgery or the treatment plan designed to treat your cancer. Age, gender, type of cancer, type and dose of treatments and any previous chemotherapy or radiation exposure can increase your risk of infertility and reproductive dysfunction. The Seattle Cancer Care Alliance (SCCA) Oncoreproduction Clinic helps to raise awareness of available reproductive health services and expedites in-system referrals for SCCA’s male and female patients seeking information and support regarding fertility preservation.
What to expect
Dr. Bo Yu is a board-certified reproductive specialist who cares for patients seen at our Oncoreproduction Clinic. She and her clinical team provide onsite, convenient consultative services for SCCA patients. Typically, this is a 60-minute visit that includes labs, ultrasound, gynecologic exam and counseling.
The clinic is supported by a dedicated social worker who provides support by educating patients and providers about available services. She also helps patients complete financial assistance requests, to navigate referral processes and bridges care coordination gaps for patients with fertility preservation concerns.
Female patients are seen at SCCA South Lake Union on Friday afternoons. Male patients are referred directly to the UW Medical Center - Roosevelt.
Insurance reimbursement and coverage of the initial appointment
Because the initial consultation is billed under the diagnosis of family planning, most insurance plans will cover it. If you have specific questions about your benefits, please contact your health insurance.
How to request an appointment
If you are an SCCA patient and are interested in consulting with a reproductive specialist, speak with your SCCA medical oncologist or you may self-refer by contacting our Oncoreproduction Clinic. Our scheduling team will provider instructions on your appointment location and how to check-in.
Cost and coverage of fertility preservation
Your follow-up appointment and fertility preservation will likely take place at Reproductive Care at UW Medical Center - Roosevelt Clinic. Costs associated with fertility preservation may or may not be covered by your insurance. Prior to your follow-up appointment, you will be able to speak with a financial counselor who will go over your benefits and the treatment costs.
You may also call your insurance directly to inquire whether infertility treatment is covered under your plan. If treatment is covered, verify if fertility preservation through an IVF cycle is a covered benefit.
Outside financial assistance may cover a portion of the costs associated with fertility preservation. Reproductive specialists can advise you on costs and financial assistance options.
Fertility after treatment
Women often stop ovulating for a period of time after treatment. Some experience premature menopause. Men often stop making sperm completely or have very low sperm counts during cancer treatment and for several months after treatment. Not every male will resume normal sperm production. Infertility can be a result of surgery, chemotherapy, or radiation. It is best to see a fertility specialist to monitor fertility after cancer treatment.
A small percentage of people, usually of younger reproductive age, do regain their fertility after treatment, but this may take months to years to occur and can be hard to predict for each person.
Routine testing of sex hormones and sperm or ovarian function is often needed to see if fertility will be restored. However, unexpected pregnancies have occurred, so please discuss your plan for birth control with your doctor to prevent unplanned pregnancy.
Protect your fertility before treatment
All patients interested in preserving future fertility should understand their options and risks before starting their treatment. Meeting with a reproductive endocrinologist and fertility specialist can help you define your best path forward.
Surgery, chemotherapy, radiation, and transplant can all affect your ability to have children after treatment.
Women often stop ovulating for several months during and after cancer treatment. Some women need to use medication that disrupts or prevents ovulation for many years after treatment. Being treated for cancer may also cause early menopause and infertility. Men often stop making sperm completely or have very low sperm counts during and after treatment. A small percentage of people, usually of younger reproductive age, do regain their fertility after treatment. This may take months to years. However, it is hard to predict for which people will or will not retain fertility. A reproductive specialist can assess fertility and let you know if assisted fertility techniques might be needed before or after cancer treatment to help with pregnancy.
For women, the standard approach is to harvest mature eggs from the ovary. Hormones are used for up to two weeks to mature the eggs before harvesting. Eggs are collected under ultrasound guided follicle aspiration. Eggs may be frozen unfertilized, or they can be fertilized (by partner or donor sperm) and stored as embryos. These eggs or embryos can be safely stored for many years until a pregnancy is desired.
For men, sperm banking is the standard approach to fertility preservation. The simplest way is to collect ejaculated sperm, but other methods can be used. Sperm can also be safely harvested from the testes and stored for many years for later use.
Adoption and other family-building options may be available after cancer treatment.
FAQ about pregnancy and cancer
Chemotherapy and radiation treatments can be very harmful to a fetus. It is very important not to get pregnant during treatment.
Even if you are not having your period, it’s possible that you could still become pregnant. If you are having sex, it is very important that you use birth control during treatment. If you think you might be pregnant or if you are having unprotected sex, it is really important for you to talk to someone on your healthcare team.
Yes. It is important that you and your partner continue to use birth control to make sure you do not get pregnant. Using condoms is extremely important, too, even if you are already on birth control. This is a dangerous time to get a sexually transmitted infection (STI).
The kinds of birth control that prevent pregnancy the best are condoms and Depo-Provera. Your nurse practitioner can prescribe Depo-Provera for you. It is possible that you may stop having your periods during your chemotherapy. This does not mean that you can’t get pregnant.
Cancer treatments can do a lot of harm to a fetus. They can cause birth defects and cause other serious problems. These treatments, medicines, and tests include:
- Radiation therapy
- X-rays, CT scans or nuclear-medicine scans
- Any type of sedation or anesthesia (the drugs that help you sleep or relax during a test or procedure)
If you are a female who is 12 or older, you will be screened for pregnancy before certain kinds of tests or treatments, and when you are admitted to the hospital. If you are pregnant, then your healthcare provider will tell you. If you are 14 or older, your provider will need your permission to tell your parent or guardian.