Ovarian cancer is a serious illness that affects the ovaries—key reproductive organs responsible for producing eggs and hormones. While it is more commonly diagnosed in women over the age of 50, younger women in their childbearing years can also be affected. For these patients, a diagnosis is not just about survival; it also raises pressing concerns about future fertility. However, medical advancements have introduced several fertility preservation options, allowing women to consider motherhood even after cancer treatment.
Ovarian cancer and its treatment can cause serious damage to fertility. Routine treatments such as surgery, chemotherapy, and radiation tend to focus on the reproductive system. Total hysterectomy, the removal of the uterus and ovaries, precludes natural conception. So, we turned to Dr. Kumardeep Dutta Choudhury, Medical Oncologist at Max Hospital, New Delhi, to understand the impact and the options available.
According to Dr. Choudhury, even when only one ovary is removed, chemotherapy can damage the remaining ovary, reducing egg quality and quantity. "As a result, it is crucial for women of reproductive age to discuss fertility preservation with their healthcare provider before starting treatment," he says.
So, what are the options if you want to keep the dream of motherhood alive?
Egg or embryo freezing, Dr. Choudhury says, is one of the most well-established techniques of fertility preservation. The technique consists of stimulating the ovaries with hormones to obtain more than one egg, which is then retrieved and frozen. "In case the woman has a partner or is interested in using donor sperm, embryos can be formed and frozen instead. The procedure usually lasts 10–14 days and should ideally be undertaken before chemotherapy starts," he explains.
Got no time to spare or still in your early teens? There is a workaround.
For females who cannot wait for cancer treatment or are prepubertal, freezing ovarian tissue is a promising solution. Dr. Choudhury says that in this method, a portion of ovarian tissue is surgically removed and frozen. After treatment, the tissue can be reimplanted to restore hormone function and facilitate natural conception.
Some women might go for a less invasive method.
According to Dr. Choudhury, ovarian suppression with hormonal therapy is another option. "Medications such as GnRH agonists may temporarily shut down ovarian function during chemotherapy, potentially protecting the ovaries from damage," he says, adding that while this method is less invasive and more immediate, its effectiveness in preserving fertility is less predictable than egg or embryo freezing.
If you catch it early, you might even get to keep part of your reproductive system.
In certain early stage cases, it can be possible to save one ovary and the uterus. It is based on the location, stage, and type of the cancer. "A gynaecologic oncologist can assess whether or not fertility sparing surgery is safe," Dr. Choudhury says.
But let us not forget that the emotional toll is real. And sometimes, you need more than just medical advice.
Facing ovarian cancer at a young age is emotionally challenging. The additional worry about fertility can raise anxiety and stress levels. It is essential to consult not only with oncologists but also with fertility experts and counsellors. They can assist in balancing the risks and benefits, discussing ethical or financial issues, and assisting patients in decision-making.
So, while ovarian cancer might change the path to motherhood, it does not have to close the door.
As Dr. Choudhury wisely points out, "Treatment of ovarian cancer affects fertility, but different preservation methods now offer hope to women wishing to be mothers later on. Taking timely action is necessary, and a multidisciplinary approach is also crucial."
In the event that you, or your close friend, get ovarian cancer at reproductive age, referring to an expert early is necessary in order to plan things and make decisions.
