According to estimates made by the Spanish Network of Cancer Registries, REDECAN, more than 286,000 new cases of cancer were diagnosed in 2024. Although advances in prevention and treatment have doubled five-year survival in the last four decades, ‘the impact of cancer on fertility continues to be a challenge for many people who are diagnosed with this disease and who intend to become parents in the future,’ explains Dr. Elisa Pérez, a gynaecologist specialising in reproductive medicine and medical director of IVF-Life Donostia.
Dr. Elisa Pérez at IVF-Life Donostia
Chemotherapy or radiotherapy treatments, although effective in the fight against cancer, can damage the reproductive capacity of both men and women. In women, the ovarian reserve or the uterus itself, if it is located in the pelvic area, may be affected.
In addition, ‘the treatment can lead to early menopause or damage to the oocytes that could affect the viability of a future pregnancy’, according to Dr Pérez. In men, however, it can damage sperm production and alter the hormone levels necessary for fertility or, in more extreme cases, it can result in the loss of the testicles, thus eliminating the ability to produce sperm.
Approximately 5.7% of diagnosed cases correspond to people aged between 0 and 44 years, a key stage for reproduction. For this reason, the cryopreservation of eggs and sperm allows cancer patients to maintain their reproductive capacity after treatment.
Egg freezing at IVF-Life
In the last decade, the number of women opting for this technique in Spain has multiplied by 15. Although 70% do so for social reasons, the rest are for medical reasons, such as protecting the ovarian reserve before aggressive treatments. Pregnancy rates using vitrified eggs in IVF-Life clinics stands at 63%, although it always depends on factors such as age and egg quality.
For men, sperm cryopreservation is a simple and effective procedure. A semen sample is collected in a specialised laboratory and then processed for freezing in liquid nitrogen, which preserves the sperm for future use. Although success rates when using frozen sperm in assisted reproduction exceed 60% in IVF-Life clinics, in Spain the rate of use of cryopreserved sperm in oncology patients does not reach 10%.
For this reason, ‘it is essential to raise awareness of these options so that people facing a cancer diagnosis can make informed decisions about their reproductive future,’ says Dr Pérez.
Age is one of the most determining factors for the success of fertility preservation. In the case of women, although the average age for egg vitrification in 2021 was 36.4 years, specialists recommend performing it before the age of 35 to guarantee better results. In men, however, the impact of age on sperm quality is less dramatic.
Although men produce sperm throughout their lives, from the age of 40 onwards a decrease in sperm motility, morphology and DNA quality can be observed, which could influence fertility and the results of assisted reproduction treatments. Therefore, although there is not as strict a limit as in women, it is recommended to consider sperm cryopreservation before this age.
Reproductive medicine has developed several techniques to help those who wish to become parents after overcoming cancer, even when they have not undergone prior preservation.
Among these options is ovulation induction in women whose ovarian function has not been completely affected, allowing egg retrieval for in vitro fertilisation (IVF). In men, sperm aspiration directly from the testicles is an alternative in cases where sperm production is limited.
Another option is gamete donation, both eggs and sperm, which allows couples to use donor genetic material to start a family. Also, in cases where the uterine capacity is not compromised, embryo transfer can be chosen for embryos generated by one's own or donated gametes.