For many young cancer patients, a diagnosis can be devastating, not just because of the threat to their health, but also due to the potential impact on their fertility. However, recent advancements in fertility technologies have provided new hope for these patients. Jenilee Crowley, a 43-year-old breast cancer survivor, is a testament to this. After being diagnosed with stage one breast cancer in 2022, Crowley was able to freeze embryos and give birth to a healthy baby boy, Archer, with the help of her medical team at Dana-Farber Cancer Institute.
Oncofertility: A Growing Field
The field of oncofertility, which bridges oncology and reproductive health, has been gaining momentum since its emergence around 2006. This growth is largely due to the increasing number of younger cancer patients and the recognition of the need to help them protect their ability to have children. According to Dr. Ann Partridge, director of the Program for Young Adults with Breast Cancer at Dana-Farber, the goal is to enable cancer patients to not only survive but also thrive and live a full life, which for many includes having biological children.
The rise in cancer cases among younger people is stark, with diagnosis rates in people under 50 increasing by 22% from 2000 to 2023, according to the National Cancer Institute. Breast cancer rates for women under 50 are rising by about 1.4% each year. Innovations in reproductive technologies have ushered in new possibilities, such as freezing ovarian tissue, which enables childhood cancer patients to preserve their fertility before hitting puberty, and egg freezing, which allows women to preserve their eggs without the need for sperm or fertilized embryos.
Challenges and Opportunities
Despite these advancements, there are still significant challenges, particularly with regards to time pressure and access to fertility specialists. Many patients need to find a fertility specialist and undergo preservation before their cancer treatments start, which can be a weeks-long process. Dr. Mary Morris, a reproductive endocrinologist at Boston IVF, noted that egg freezing has been the biggest part of the progress in oncofertility, but the time pressure and lack of awareness about fertility preservation options remain significant hurdles.
Some patients, like John Ballou, who was diagnosed with Hodgkin’s lymphoma at 23, struggle to access fertility services due to insurance issues or waitlists. Ballou had to wait nearly a month to get an appointment for sperm banking, which added to his stress and uncertainty about his future. The cost of fertility preservation is also a significant consideration, with embryo freezing costing up to $20,000 without insurance. However, there is growing momentum to increase insurance coverage, with several states passing legislation to mandate coverage for fertility preservation for cancer patients.
A New Era in Fertility Preservation
Research has also been advancing in the field, with studies like the one conducted by Dr. Partridge and her team at Dana-Farber, which found that survivors of early, hormone-sensitive breast cancer could pause their hormone therapy for up to two years to get pregnant without raising the risk of cancer recurrence. This study has significant implications for cancer patients who want to start families after treatment.
Crowley’s story is a testament to the progress being made in oncofertility. After pausing her hormone therapy, she and her husband were able to freeze embryos and try for a baby. Although the journey was not without its challenges, including multiple miscarriages, they were eventually able to welcome their son, Archer, into the world. Crowley is now considering using their final embryo to try for a second child, weighing the risks and benefits of extending her time off treatment.
Helene Elliott is the senior reporter for News Raise. She covers Science news. She also has a keen interest in photojournalism. Helene holds a nomination for the prestigious Red Smith Award. She is married to author Dennis D’Agostino, a former publicist with the New York Mets.
