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Cancer and Fertility Preservation
In the United States there are approximately 800,000 little evidence to support suppression of the ovaries reproductive-aged men and women who have cancer, before cancer therapy with birth control pills, GnRH many of whom have concerns about their fertility. Life- agonists, or other means of hormonal suppression. saving cancer treatments may reduce fertility by destroy- Freeze eggs. This technology is investigational, ing eggs and sperm. The likelihood of reproductive dam- expensive, invasive, and may delay cancer treatment. If age depends on the age and sex of the patient and the type used,eggs are collected as for IVF but are frozen before and duration of treatment. The most severe damage comes they are fertilized. Theoretically, frozen eggs may be from radiation to the ovaries or testicles and cancer drugs stored, thawed, fertilized, and used for embryo transfer.
in the “alkylating agent” category such as cyclophos- Actual success with this method is very limited, and few phamide, mechlorethamine, chlorambucil, and melphalan.
babies have been born with this technique. Although sperm production may recover, eggs do not Freeze ovarian tissue. This experimental technique regenerate; their loss is permanent and premature requires surgery to remove ovarian tissue. Once frozen, menopause may occur as a result. The risk of developing tissue may be stored for years. Preliminary studies have premature menopause is lower for younger women than shown that reimplanted ovarian tissue may survive and for older women. The first goal is to cure the cancer, even function for a limited time, but no babies have been born if the treatment causes sterility. However, there are several options that may help preserve fertility before and after Fertility after cancer treatment
• Men. It may take up to several years for sperm produc-
tion to recover after cancer treatment. If sperm counts are
Preserving fertility before cancer treatment
consistently low, insemination, IVF, and ICSI may be • Men. Semen samples may be frozen at a sperm bank or
effective measures for achieving pregnancy. Testicular fertility center before starting chemotherapy or radiation biopsy may be a way to obtain sperm if sperm are not therapy. Samples can be stored for years and used later for found in a semen analysis. If sperm cannot be obtained, insemination. Sperm counts may be low or absent as a pregnancy may be possible by using frozen donor sperm.
result of the underlying cancer. If sperm counts are low The physician may want to wait up to six months before and/or the supply is limited from the frozen sample, the attempting conception. Some couples may choose to pur- sperm can be used for in vitro fertilization (IVF) and intra- • Women. After the physician has advised that attempting
• Women. If time and circumstances allow, women may
pregnancy is safe, women may want to consult a fertility be treated with IVF. Embryos created by IVF are then specialist to check for damage to reproductive organs.
frozen and may be stored for years. Limiting factors for Many women will be able to conceive naturally or with this approach include time, expense, availability of sperm, fertility treatments. If significant damage has occurred to and possible delay of cancer therapy. If radiation will be the ovaries or uterus, couples may wish to consider egg or administered to the pelvis, the ovaries may be repositioned embryo donation, a gestational carrier, or adoption to cre- surgically out of the radiation field. This will reduce the risk that radiation will damage the eggs.
• Areas of research:
Ovarian suppression before cancer therapy. In theory,suppressing ovarian function may protect the eggs against the adverse effects of cancer treatment. There is The American Society for Reproductive Medicine grants permission to photocopy this fact sheet and distribute it to patients.



Urologie • Andrologie Dr. Lock + Wieskerstrauch ] zur erektilen Impotenz | 1 Erektile Impotenz oder erektile Dysfunktion: Unvermögen des Mannes, den Geschlechtsverkehr aufgrund einer nicht aus- reichenden Versteifung des Gliedes zu vollziehen Die erektile Dysfunktion ist ein großes gesundheitliches Problem mit negati-ven Konsequenzen für den Patienten und seine Partnerin. Heute we


The following is a list of the most commonly prescribed drugs. It represents an abbreviatedversion of the drug list (formulary) that is at the core of your prescription-drug benefit plan. The list is not all-inclusive and does not guarantee coverage. In addition to using this list,you are encouraged to ask your doctor to prescribe generic drugs whenever appropriate. 2010 Express Scripts PLEAS

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