New options expand possibilities for fertility preservation in cancer patients.

Doctors can now harvest eggs from frozen ovarian tissue implanted in a woman's forearm or abdomen. The technique is just one of several new treatment options that may soon be available for women who face both cancer and possible treatment-related infertility. The American Society for Clinical Oncology released guidelines on fertility options for cancer patients earlier this year, which has shown a spotlight on the problem often faced by premenopausal women. New options include procedures that preserve the ovaries before treatment and changes in vaginal surgery techniques that could alter the outcome for premenopausal women. Although the number of women who become infertile after cancer treatment is unknown, 113 women per 100,000 under age 50 are expected to get cancer each year in the United States. Infertility can affect patients with any cancer treated with radiation therapy or che-motherapy, but the greatest risks are from chemotherapy involving alkylating agents or whole-body radiation. Surgeries that are common for ovarian and cervical cancers can also compromise fertility. When weighing their options, patients also must take into account the high cost of fertility treatments that are uncertain to yield a child in the future. And many researchers worry that such uncertainties won't improve in a fi eld that lacks a consistent avenue for funding. " None of the fertility preservation methods is clearly effective. All of them tend to be expensive, unless there's a research protocol that pays for medications or procedures, " said Leslie Schover , Ph.D., a behavioral scientist at the University of Texas M. D. Anderson Cancer Center in Houston, who studies parenthood after cancer. " Some women will choose not to spend large amounts of money if they can't be sure a procedure will do them any good. " New Fertility Options Currently, women can take measures to preserve their ability to have children after a cancer diagnosis, but the available options are limited, particularly for patients who need immediate cancer treatment. Fertility preservation is limited mostly to egg and embryo cryo-preservation; women take fertility drugs and hormones to produce large numbers of eggs, which are frozen alone or fertilized and frozen as embryos. Embryo cryo-preservation is generally recommended over egg cryo-preservation because the eggs are more fragile and the egg freezing process is not as well developed. The entire process can take 6 weeks — a long delay for patients with high-risk cancers. Fertility drugs may also be …