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Fine-tuning Fertility treatment "Up until recently, most people weren't aware how successful egg freezing can be, and that it can be done quickly," Schoolcraft says. "So they thought it was out of the question." But advanced technology and new knowledge are shaping fertility treatment today, such as the experts' relatively recent discovery that use of frozen rather than fresh embryos results in higher pregnancy rates. "The entire paradigm has changed," Riggs says, a shift that is good news for cancer patients. By the time frozen embryos are transferred to the woman's womb, which can be years later, her body isn't in a flux from a rash of hormone- manipulating fertility treatments, as is the case with women undergoing in vitro fertilization with fresh embryos, Schoolcraft says, explaining the suspected reason for the improved pregnancy rates. "So, for cancer patients, if the question of their future partner is not in doubt, going ahead and using his sperm to fertilize the egg allows for a higher rate of success (about 10 percent better)," Schoolcraft says, adding that the younger the patient, the better the rates as well. The average successful pregnancy rate for 30-year-olds is 70 percent for embryos and 60 percent for eggs, Schoolcraft says. For patients not in committed relationships, the process of freezing eggs has also improved, boosting pregnancy rates. CCRM and Conceptions now use a rapid method of cryopreservation known as vitrification, which avoids damage to the cell that sometimes occurred with the slower freezing process used for the past 20 years. Advancements have also allowed fertility specialists to offer some form of hope to cancer patients, even if they don't want to wait the average six weeks for retrieving fertile eggs. "We used to think that we had to wait until a woman had a period," Schoolcraft says. "We now have ways with medications to make her period come in three or four days and start immediately, so we can now complete the process in two to three weeks." And if a woman doesn't want to wait even that long to begin cancer treatment, another option involves doctors retrieving the eggs and then maturing them in the lab before freezing (in vitro maturation). "That's not quite as successful as harvesting mature eggs, but our techniques with in vitro maturation have improved from three or four years ago," Schoolcraft says. Both doctors say fertility counseling before cancer treatment can be tough for patients. "The hardest part is just the sheer panic they are going through," Schoolcraft says. "Suddenly, they are thrust into coping with a diagnosis of cancer and also having to think about long-term fertility. It's just a lot of decisions to deal with in a short amount of time. Yet, Riggs says, as stressful as it can be, when the cancer becomes the past, and a family becomes the future: "Most patients will find that it was time well-spent." 48 At the Sky Ridge Breast Cancer Center, co-chair Dr. Joyce Moore and her fellow oncologists urge patients to take the time for fertility counseling to prevent future regrets. "We can't guarantee they will be fertile coming out of treatment, so planning ahead is key. Especially today, with so many women choosing to postpone childbirth for career and other reasons, fertility is a significant issue," says Moore, whose young-patient load, for reasons unknown, is 10-percent higher than the national average. By 7he numB3rs of 1,041 women surveyed who were diagnosed with cancer between ages 18 and 40 years: Women who were counseled by a fertility specialist before cancer treatment reported higher quality of life and lower sense of regret years later. Source: University of California San Francisco School of Medicine, published in the journal "Cancer." DiD you know? u.s. cancer survivors of reproductive age now number nearly 500,000. – National Cancer Institute were not counseled at all about their treatments' potential effect on fertility and their options. were counseled by an oncologist only. were counseled by a Fertility specialist.