Supportive Care Services

Oncoreproduction Clinic

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 Fred Hutchinson Cancer Center Oncoreproduction Clinic helps to raise awareness of available reproductive health services and expedites in-system referrals for Fred Hutch patients seeking information and support regarding fertility preservation.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.

What to expect

Mary Sienkiewicz, ARNP 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 Fred Hutch 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. Our social worker 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 the South Lake Union clinic every other Wednesday. 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. 

Ultrasound A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen. A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen (sonogram). Ultrasound may be used to help diagnose diseases, such as cancer. It may also be used during pregnancy to check the fetus (unborn baby) and during medical procedures, such as biopsies. Also called ultrasonography.

How to request an appointment

If you are an Fred Hutch patient and are interested in consulting with a reproductive specialist, you may speak with your Fred Hutch medical oncologist or you may self-refer by contacting our Oncoreproduction Clinic directly. Our scheduling team will provide instructions on your appointment location and how to check in. 

Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists.

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Fred Hutch Oncoreproduction Clinic

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. 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 health 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.

Reproductive Care at UW Medical Center - Roosevelt

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Reproductive Care at UW Medical Center - Roosevelt

Fertility after treatment

Women often stop ovulating for a period of time after cancer 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 man 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 physician to prevent an unplanned pregnancy.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy.

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.  

Preserving options

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.

Ultrasound A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen. A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen (sonogram). Ultrasound may be used to help diagnose diseases, such as cancer. It may also be used during pregnancy to check the fetus (unborn baby) and during medical procedures, such as biopsies. Also called ultrasonography.

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.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy.
Is it possible to get pregnant during treatment?

Yes. Even if you are not having your period, it is possible that you could still become pregnant. If you are having sex, 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. If you think you might be pregnant or if you are having unprotected sex, it is important for you to talk to your health care team. This is also a dangerous time to get a sexually transmitted infection (STI).

If I am having sex, what kind of birth control should I use?

Contraceptive options containing estrogen are often not recommended for those with cancer. Talk to your reproductive health specialist about the safest and most effective contraceptive option for you. And remember that condoms are always recommended to protect against sexually transmitted infection.

If I am pregnant, will my treatment hurt my fetus?

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:

  • Chemotherapy
  • 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)
Anesthesia Drugs or other substances that cause a loss of feeling or awareness. This keeps patients from feeling pain during surgery or other procedures. A loss of feeling or awareness caused by drugs or other substances. Anesthesia keeps patients from feeling pain during surgery or other procedures. Local anesthesia is a loss of feeling in one small area of the body, such as the mouth. Regional anesthesia is a loss of feeling in a part of the body, such as an arm or leg. General anesthesia is a loss of feeling and a complete loss of awareness that feels like a very deep sleep. Computed tomography A procedure that uses a computer linked to an X-ray machine to make a series of detailed pictures of areas inside the body. The pictures are used to create three-dimensional (3-D) views of tissues and organs. A procedure that uses a computer linked to an X-ray machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create three-dimensional (3-D) views of tissues and organs. A dye may be injected into a vein or swallowed to help the tissues and organs show up more clearly. This scan may be used to help diagnose disease, plan treatment or find out how well treatment is working.
Will I have routine pregnancy screening during treatment?

If you are a female patient who is 12 or older, you will be screened for pregnancy before certain types of tests or treatments, and when you are admitted to the hospital. If you are pregnant, then your health care provider will tell you what to expect. If you are 14 or older, your provider will need your permission to tell your parent or guardian.

Resources

UW Medicine Male Fertility Lab
Full-service clinical andrology lab, providing patients and providers with male fertility testing.
Livestrong Fertility
Helps patients understand fertility risks, options and allows access to fertility preservation discounts.
The Oncofertility Consortium
An online fertility preservation toolkit for patients and their providers.
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