When I was diagnosed for the second time in two years with tongue cancer, I was told that the chemo I would have to have might leave me infertile. In the face of life and death, this may not seem like an issue that should take priority, but for me, it was huge. My surgeon admitted that she didn't have many answers, and couldn't be as helpful as we both would have liked, so I decided to proactively seek out answers for myself.

In the weeks before I started chemotherapy, I threw myself into research about what fertility options were out there. I discovered that information was hard to find, that guys have better options than women, and that insurance companies rarely covered anything.

I was fortunate. I discovered an experimental egg-freezing treatment and was given the chance to preserve what was sacred to me, my fertility. If nothing else, it made me feel that I had done everything I could do to protect myself and my future fertility. But the whole experience left me wondering how many people slipped through the cracks without critical information on fertility options.

To meet this need, I founded Fertile Hope, a nonprofit organization dedicated to providing information, support and hope regarding cancer and fertility. There is a lot to consider before, during and after treatment, and many reproductive decisions must be made in the short time frame between diagnosis and treatment. Nothing is guaranteed – fertility or infertility – but the problem is that you will not know for sure what has happened until after treatment, when it is often too late to do anything.

You should consult your medical team and your insurance provider when considering any and all of the following treatments described below. The treatments can be expensive, and they are not always covered by insurance, although some patients have had success petitioning their insurance providers for coverage.

Gathering Information

The first step in gathering information is to ask questions of your medical team, such as:

• Will my treatment have any short- or long-term side effects on my reproductive system?
• Is infertility a possible side effect?
• Are there alternative ways to treat my cancer that will result in less damage to my reproductive system?
• What are my fertility preservation options before, during and after treatment?
• Would using any of these options possibly make my cancer treatment less effective?
• After treatment, how will I know if I am infertile?
• If I become infertile after treatment, what are my options for becoming a parent?
• How long after treatment should I wait before trying to conceive?
• Can you refer me to a fertility preservation specialist?

Your doctor may not be able to answer all of these questions but, if not, he or she should be able to help you seek out a specialist who can.

Fertility Options

• Sperm banking: Proven, successful and readily available. Sperm is donated, analyzed, frozen and stored indefinitely. It is an outpatient procedure available for guys after puberty. Success rates vary depending on quality of sperm, and multiple donations are usually recommended, but even one sperm may be enough for conception using ICSI (Intracytoplasmic Sperm Injection).
• Testicular tissue freezing: Still experimental, no live births to date. Testicular tissue, including the stem cells that produce sperm, is surgically removed, analyzed, frozen and stored. Available for guys before and after puberty.
• Testicular sperm extraction: Still experimental, small number of births to date. Post-treatment, if you are no longer producing sperm, you can have your testicular tissue examined to see if there are any remaining sperm cells in the tissue. If found, the sperm is removed and used with in vitro fertilization in an attempt to yield pregnancy.
• Donor sperm, donor embryos, adoption and child-free living may also be considered

Will my treatment affect my children's health?

Research thus far is reassuring, but the number of studies is still small. If you're considering parenthood after cancer treatment, there are some factors to be aware of, and that you will want to discuss with your medical team:

• Sperm cells exposed to chemotherapy or radiation may suffer genetic damage. This damage appears to be repaired two years after treatment.
• Rates of birth defects in children born after one parent's cancer treatment appear similar to that of the general population.
• No unusual cancer risk has been identified in the offspring of cancer survivors (except in families identified with true genetic cancer syndromes, for example, inherited retinoblastoma)