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For those of us with ovaries, we have the most eggs we will
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ever have while we’re still in the womb. We’re born with about a million of them and
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that number only goes down from there. We’ll release about 300-500 of those eggs
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throughout our lifetime, but there are lots of things that can make that number even smaller.
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One of those things is cancer.
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Now, cancer is a really scary thing and it’s
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an overwhelming wave of tests, diagnoses, and treatment options. And then there’s the cherry
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on top of all the extra stuff there is to worry about...stuff like fertility.
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-What happens is that the chemotherapy
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can cause the eggs that are currently active in the ovary to undergo basically
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cell death. And that can lower a person's egg supply more quickly than what happens naturally.
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-The word chemotherapy actually means any drug used to treat any kind of illness,
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but in the context of cancer treatment, these are drugs that are targeted at eradicating cancer cells.
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And these drugs may not only affect active eggs but can also degrade the backup pool of eggs
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that’s stored in the ovaries for future ovulation. And chemo isn’t the only kind of
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cancer treatment—the two other most common are radiation and surgery .
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Then there’s options like immunotherapy, hormone therapy, bone marrow transplants,
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and lots of other emerging medicines. Radiation in the pelvic area can also
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directly harm your eggs.
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And any destruction of hormone-regulating parts of the body, like the ovaries, can trigger some
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pretty drastic changes, including the onset of menopause-like symptoms before age 40.
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But the effect of any of these treatments really depends on the kind of cancer
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you may be dealing with. Which in Betty’s case, it was acute lymphocytic leukemia.
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-My oncologist told me if I would have not been diagnosed for two more weeks,
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I probably would have not survived. That's how quickly it was escalating.
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-Every kind of cancer is relatively unique, so treatment is going to be tailored to
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the stage and type of the disease and the age and general condition of the patient.
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So after hearing all of that, it’s understandable that fertility planning
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is a pretty actually big part of someone’s cancer journey.
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My oncologist explained that the chemo would
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potentially put me in early menopause or give me issues conceiving. So he was very clear
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on explaining to me what could happen and the possibility
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of me having a child.
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-Some of you may already know this,
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but in my last relationship, my long-term partner was diagnosed with a really aggressive lymphoma.
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Everything I just said about ovaries is also true for male reproductive equipment. Chemotherapy
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can damage sperm and sperm-generating parts of the body, so before treatment,
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he needed to consult a fertility specialist. For those with testes, that means deciding
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whether you want to collect and store a sperm sample. But for those with ovaries,
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it’s a little more complicated.
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-There are a variety of options.
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The most commonly used option is egg freezing, where a patient undergoes an ovarian stimulation
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cycle to try to get all the eggs that are present in the ovaries for that month to grow together.
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We would then do a procedure that's under sedation to remove those eggs from your ovaries. Just using
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a needle that goes through the vagina takes about 15 to 20 minutes and you go home the same day.
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And we can freeze all of the mature eggs that we get to use in the future either to carry yourself
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or to be carried by someone else.
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-And that whole process takes time,
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like at least a couple of weeks.
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An even more recent option is ovarian transposition.
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This is where the ovaries are actually surgically moved higher up into the abdomen
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so they’re out of harm’s way if radiation is being aimed in that direction.
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The ovaries are moveable! Who knew, huh? Not me.
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But sometimes, things actually progress too fast. Some patients, like Betty, don’t
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have the luxury of time to explore all options before they urgently need to start treatment
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for their cancer.
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-Unfortunately, due to the rate of the cancer growing and how fast I was deteriorating,
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I was given the option to freeze my eggs, but it would postpone treatment for two months
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which would make my prognosis very bleak. So me and my ex husband made a decision
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to go ahead with treatment because we already had our newborn.
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-It’s a tough decision to face. Luckily, there are some exciting advancements on the horizon, like...
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artificial ovaries. This is where the patient’s own ovarian tissue is removed and frozen,
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a technique known as cryopreservation.
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It can then be used to create a scaffold, seeded with their own ovarian follicles.
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And all of this can then be prompted to function as an ovary and produce eggs
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outside of the body. We’re livin’ in the future, dude!
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It can then be transplanted back into the body, where the hope is that it could resume
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function as a normal ovary again. This research is still in its early
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stages and has only been trialed in lab animals so far, but it’s a promising future option.
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Other experimental ovarian cryopreservation techniques have
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been tried successfully have resulted in live human births.
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Plus, something that’s just as important as these advancements
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is who exactly will have access to them. -A patient has to be aware that these services
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exist, if they don't ask for it themselves. And so empowering our cancer specialists to know about
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the ways that we can assist patients to preserve their fertility, and just kind of spreading the
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knowledge amongst the practitioners. -And we can’t forget that all of this
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costs money. -I wish I could say that fertility preservation
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was free. But there's also some great societies out there that provide grants for
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patients to help offset some of the costs. And so we try to meet patients, you know, kind of where
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they are to get them the care that they want.
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And depending on the kind of cancer,
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and the kind of treatment, experts recommend that cancer survivors wait anywhere from six months to
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five years before trying for kids. The waiting period reduces the chance of a
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cancer recurrence and gives the patient adequate time to recover, both physically and otherwise.
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There are lots of folks who complete cancer treatment and go on to have
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low-risk pregnancies and healthy children. Like Betty,
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who got pregnant shortly after getting the green light from her doctor without any fertility help.
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-I never expected to get cancer as a new mom at 30. I never expected to have a
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second child after I was told that I possibly could not have another child. So stay positive,
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do your research, figure out what you want for your life and your future and where you stand
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and always always advocate for yourself because no one else is going to do it better than you.
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-If you or someone you know is looking for support when dealing with blood
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cancer, check out The Leukemia and Lymphoma Society. They provide patients with free,
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one-on-one support and opportunities to speak with highly trained oncology professionals.
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To learn more about them, check out the resources we’ve left in the description below.
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Thanks so much for watching Body Language, if you want more topics from the series,
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check out season one here. If there are any other health topics
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you think we should cover, let us know in the comments below.
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I really hope you learned something new in this video and I'll see you next time.