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The point of return
Two years ago, Aditya Srivastav was diagnosed with leukemia. He was just 28 years old. Before starting treatment on Srivastav, Dr Bhawna Sirohi, head of medical oncology at Artemis Health Institute advised him to bank his semen samples as chances were high that the chemotherapy and radiation regimen could render him infertile.
Srivastav agreed and froze his samples in a sperm bank. Today, two years later, Srivastav is cancer-free, married and planning a baby.
Cancer and its treatment can sometimes affect a person's ability to have children but banking of eggs of cancer-afflicted women and semen of male patients tremendously increases their chances of parenthood once free from the disease. Sirohi says, "I always ask my patients, even those aged 40, to bank their samples before chemotherapy or radiation in case they want to experience parenthood. The samples are saved for life in liquid nitrogen. "
To preserve semen samples is easy. But for women, it can take almost 2-6 weeks, " adds Sirohi. Semen cryopreservation of at least three samples with 48-hour abstinence intervals is recommended for men. For azoospermic men (low/nil sperm count), testicular biopsy and sperm extraction may be an option for fertility preservation.
"However it is tougher for women. We might have to delay treatment to almost a month. A lot depends on the type of cancer. Since cancer is a deadly disease, some patients don't want to delay treatment, " says Dr Anupama Hooda of Max hospital.
Hooda's advice to young patients is simple - before you start cancer treatment, talk to your doctor about any concerns you have about your fertility later on. A recent Dutch study says that cancer patients who have had semen samples cryopreserved because of the possible adverse effects cancer or its treatment have on their fertility, appear to have a 50 per cent chance of achieving parenthood.
To determine the usage rate and outcome of assisted reproduction technology employing cryopreserved semen, Dr Niels van Casteren (lead investigator) of Erasmus University Medical Center, Rotterdam, and colleagues conducted a review of data on 557 men from whom a total of 749 semen samples were preserved. Of the total of 101 assisted reproduction technology cycles performed, 25 children were born - 19 single infants and three sets of twins. "These men would not have been able to do this without their stored semen, " the study adds.
According to Sirohi, the toxic effects of ionising radiation, chemotherapy and surgery on testes/ovaries depend on the patient's age, line of treatment, total dose and nature of "insulting agents. "
"All cancer patients face the risk of infertility. Those patients who have not had a child till their treatment should discuss germ-cell storage options with the medical team, " she says.
ON THE RISE
Cancer affects 10 lakh Indians every year and kills another 4 lakh
There are 25 lakh cancer patients at any given point
It is the third biggest killer in India
The results of treatment in stage I and stage II (early stage cancer) are about 80 per cent
In late stage diseases (stages III and IV) the results are less than 20 per cent
In India, about 70 per cent patients have advanced stage disease and are therefore difficult to treat
By 2015, the number of new cases in India is expected to cross 15 lakh
In males, lung, head and neck cancers are the most common
In women, breast and cervical cancers are the most frequent
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