Cancer patients freezing eggs and sperm more than ever, but barriers remain

The day Ally Galea met her cancer specialist, he asked her to think about her fertility.

She was 21 and had just been diagnosed with Hodgkin’s lymphoma.

“I was sitting there thinking, ‘Oh God, I haven’t even thought about that,'” Ms Galea said.

Before starting weeks of chemotherapy and radiotherapy, she had an injection to protect her reproductive organs from the medicine.

After finding out she needed to go through another round of treatment, she had to make a big decision — and fast.

“I basically had ahead of me some really high-dose chemotherapy and then a stem cell transplant,” she said.

“I was told there was a 70 to 80 per cent chance I would end up infertile after that.”

Ally Galea does not know whether she will use her frozen eggs, but is thankful she has the option.(Supplied: Ally Galea)

Ms Galea was given the choice to either freeze her eggs or her ovary tissue.

She opted for the eggs, and what could have been a long and difficult process ended up being successful on the first try.

“For my first go I had around 26 viable eggs and I’ve got them sitting in a freezer somewhere for me,” she said with a laugh.

Ms Galea, now 24, is undergoing “maintenance treatment” for the cancer and says she is grateful to have had that initial conversation.

“[I won’t use my eggs] in the near future, but it’s nice to have that option,” she said.

“I know not everyone’s given that option.”

‘Enormous improvement’

Austin Hospital clinical haematology director Andrew Grigg said it was now common for oncologists speak with patients about fertility in the small window before treatment.

Two women in hospital smiling at the camera, one with tubes coming out of her arm Melbourne-based Ally Galea receiving treatment for her cancer with partner Dana by her side.(Supplied: Ally Galea)

He said while many patients were naturally fertile after cancer treatment, it was always important to have the conversation.

“[In the public system] if a young person comes in with lymphoma or leukaemia – both men and women – one of our highest priorities is talking about fertility,” Dr Grigg said.

“I’m lucky enough to have five senior nurse counsellors at the Austin 
 who will generally meet with the patient within 24 hours of their diagnosis, discussing what needs to be done.”

Royal Women’s Hospital reproductive services head and Melbourne IVF clinical research head Kate Stern said there had been an “enormous improvement” in awareness and understanding about cancer patients and fertility.

“It used to be all about curing the cancer and there’s no time for anything else,” she said.

“Now it’s important to have the conversation, even if the patient decides they don’t want to do anything.”

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Dr Stern’s team at Melbourne IVF is on call 24 hours a day, consulting with women, men, and children within the small window of time between cancer diagnosis and treatment.

She said the clinic received 100 to 200 referrals a year for urgent fertility preservation discussion, with 70 to 80 per cent choosing to continue with the service.

Although it differs between providers, she said the cost for cancer patients was generally low or free and that egg, sperm and tissue transport services were available for patients in regional and remote communities.

Dr Stern said women also had the option to now freeze ovary tissue, which was preferred if there was a high risk of losing fertility, or if the patient could not afford to hold off treatment for the 10 to 14 days required to extract eggs.

“[Freezing tissue] is not experimental anymore — it’s a life-changing thing,” she said.

Blue gloves reach into a drum containing frozen eggs for fertility treatments. Dr Stern says it is important that cancer patients discuss fertility as close to diagnosis as possible.(ABC News)

Barriers remain

While there is a national framework for cancer patients and accessing fertility preservation, Dr Stern said some patients were still being left behind.

She said some had missed out because some specialists were not comfortable talking about fertility, or because of difficulty accessing telehealth appointments.

“We know that there are still some people falling through the cracks in regional and rural areas who don’t know about it and are not being referred,” she said.

“Education and geography shouldn’t be barriers 
 but very important inroads have been made.”

Dr Stern encouraged anyone diagnosed with cancer to speak with their specialist about their fertility if they had not done so.