How can one determine the degree to which cancer treatment will threaten fertility?

One of the critical factors here is that every individual experiences the cancer and the chemotherapy and radiation individually. Cancer is very personalized. What we try to do is provide broad options, but you really have to look at each individual and in fact their age, and the chemotherapy they’re going to get, the regiment, and the timeline to understand what the fertility threat really is. So this is really a complicated kind of algorithm. That is why we provide to particular physicians all the information that allows them to help factor all these things in.

So for a young woman with cancer, in some cases, the chemotherapy may not impact her fertility dramatically, and a young woman needs to know that—if this treatment is not going to impact the ovary, she needs that information. Some chemotherapeutics will actually eliminate the ability of the woman to go through menstrual cycles and will impact eggs when they are in the maturing phase of the cycle. So she might lose her cyclicity, her menstrual cycles, for the length of time she’s on chemotherapy, but then after the chemotherapy ends, she will resume normal menstrual cycles. Now, she may go through an earlier menopause, and that length of time from the end of treatment to menopause, may be variable by 10 years, and so she may have a reduced time of going through normal cycles and, therefore, having natural fertility options available to her.

And then there’s the third case which is the acute and continual loss of fertility as a consequence of treatments. Some chemotherapeutics, like alkalating agents, will in fact eliminate all the follicles within the ovary at any age. So really understand the treatment type and your fertility index as a consequence of that treatment is really critical. There certainly are women who’ve gone through cancer treatment and have had their own children down the line. And so understanding what the fertility threat is to you as an individual, in a personalized way, is really one of the things that we’re trying to promote.