by Lisa Campo-Engelstein, Ph.D., Assistant Professor Alden March Bioethics Institute & Dept. of OBGYN, Albany Medical College
Approximately 10% of people diagnosed with cancer are within their reproductive years (generally defined as under 45).[i] Although life-saving, cancer treatments (e.g. radiation, chemotherapy, and surgery) can also lead to infertility in both females and males. Established reproductive technologies for women and men like gamete freezing and embryo freezing allow cancer patients to preserve their fertility in case they want to become biological parents in the future. As survival rates have increased, fertility preservation has become a more significant quality of life issue.[ii] Indeed, both young women and men state that the fertility preservation is important for them and the majority of those who are childless at the time of their cancer diagnosis express a desire to have biological children in the future.[iii],[iv]
by Samantha Yee, Co-Editor CKN OFRN Content, Social Worker, Centre for Fertility and Reproductive Health (CFRH), Mount Sinai Hospital. Doctoral Program, Factor-Inwentash Faculty of Social Work, University of Toronto
Some cancer types, cancer treatments and cancer drugs have side effects on the reproductive system, and may temporarily or permanently affect your ability to have children. The risks to fertility vary, and are highly dependent on your gender, your age at diagnosis, your cancer treatment and doses of drugs, and your past reproductive history. For males, it means they may have more difficulty getting their partner pregnant. For females, it means they may have more difficulty conceiving and carrying a pregnancy.
by Sara Cohen, Lawyer
As is often the case, I am working with clients right now who are contemplating surrogacy as an option to build their family as a result of cancer. Cancer has stolen time, health and peace from this woman. It has also stolen the ability for this woman to be able to carry her own child. It is sad, it is disappointing. But, there is hope. There is hope because this client, unlike so many of my other clients, was able to undergo IVF and create embryos prior to undergoing her chemotherapy and radiation treatment. There is hope because this client, unlike so many of my other clients, had an oncologist who was familiar with the idea of fertility preservation. There is hope because this client, unlike so many of my other clients, will still have the chance to have a child with her brown eyes and her kind smile. Cancer stole so much from her, but there is hope that cancer has not stolen her opportunity to be a mother.
It shocks me how few of my clients hear information about fertility preservation until it is too late. It seems this tide is slowly changing, and hope is existing where none existed before.
Enter: CKN Oncofertility Referral Network
Sara R. Cohen, LL.B. is the founder of Fertility Law Canada at D2Law LLP where her legal practice is exclusively devoted to reproductive law issues. She is based in Toronto, but with clients throughout Canada and beyond. She approaches fertility law with the compassion, empathy and respect it deserves. Sara’s passion is to help build families and she considers herself very fortunate to have such a fulfilling career. Sara regularly acts on behalf of intended parents, surrogate mothers, egg donors, sperm donors, and other people involved with reproductive technologies. She also provides legal advice to domestic and international businesses in the fertility industry. Sara is an elected fellow of AAARTA (American Academy of Assisted Reproductive Technology Attorneys), the legal representative on the Ethics Committee at Lifequest Centre for Reproductive Medicine, a member of the Executive Counsel of the American Bar Association’s Family Law Section, ART Committee, a member of Canadian Fertility and Andrology Society (CFAS), an Adjunct Professor or Reproductive Law at Osgoode Hall Law School, and a Director of Canadian Friends of Haifa University.Sara has been widely quoted in the media about issues relating to fertility law in Canada. She is an advocate for all parties involved in third party reproductive technology. Sara loves what she does and it shows!
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by Lisa Feldstein and Alissa Goldberg
Health professionals know the drill. You need the patient to sign the consent form before proceeding with a treatment or procedure. But what is often forgotten is that a signature alone is not sufficient. Informed consent – the kind required by law – is not just a form, but a process. It means explaining to the patient the risks, benefits, and alternatives to the proposed treatment or procedure. It means giving the patient an opportunity to ask questions, and answering those questions. Health professionals who fail to obtain informed consent face liability if something goes wrong.
by Megan Johnson Shen, Ph.D.
Regardless of their gender, patients undergoing treatment for cancer list their future fertility as an important concern (Mersereau, 2012). This issue is so important that 66% of cancer patients express a desire to have children in the future (Schover, Rybicki, Martin, & Bringelsen, 1999) and female cancer survivors rate concerns about having children in the future as second only to fears of recurrence (Connell, Patterson, & Newman, 2006). Despite the fact that fertility preservation is of great concern to most cancer patients, there is currently very little guidance on how to incorporate one’s partner into the discussion. However, it is critical to learn how to involve partners and spouses in these discussions, as patients rate discussing fertility issues with their partners as more helpful than discussing it with their oncologists (Tschudin et al., 2010). This brief article attempts to outline some of the issues and concerns that should be considered when incorporating spouses and partners into oncofertility discussions.
Photo Credit: Michael Dwyer for The New York Times
by Anahad O’Connor, NYT
Like many adults who survived childhood cancer, Karen Cormier always assumed she would never get pregnant.
Ms. Cormier, 39, developed a rare form of kidney cancer when she was 5 years old. Chemotherapy helped cure her of the disease, but her doctors warned that the treatments would damage her reproductive organs, almost certainly leaving her infertile.