Receiving a diagnosis can change everything overnight. One call from your physician can put life on pause, leaving you with a new journey to navigate — and so many questions.

As you process everything and get your questions answered, make sure to cover all of the bases of your health. If your diagnosis or upcoming medical treatments could potentially impact your fertility, have a conversation with your doctor about fertility preservation.

Fertility preservation helps to protect your fertility

Fertility preservation is a process that can preserve a person’s ability to have children. It involves retrieving and cryopreserving (freezing) eggs, embryos, sperm, or reproductive tissue for future use. (Learn more about fertility preservation options for women.)

There are many reasons someone might consider fertility preservation, but it’s especially important to explore this option if:

Your fertility is actively and rapidly declining
Your fertility is expected to decline as the result of an upcoming medical procedure

What kinds of medical conditions or procedures can impact your fertility? Read about common examples.

Medical reasons for fertility preservation

Fertility preservation before cancer treatment

With nearly 2 million people in the US being newly diagnosed with cancer each year, cancer treatment is one of the most common medical reasons people undergo egg, embryo, or sperm freezing.

Both cancer itself and related medical treatments (including chemotherapy, radiation, hormone therapy, and surgery) can impact fertility in women and men. Adverse effects on fertility depend on a range of factors in a person’s care plan:

Medications given
Dosage and locations of radiation therapy
Organs impacted by surgery

How do chemotherapy and radiation impact fertility?

First, going through chemo or radiation doesn’t necessarily mean your fertility will be affected. Your oncologist can answer questions about your level of risk based on your specific type of cancer and treatment plan.

Generally speaking, radiation and chemo can affect fertility in a few ways. These procedures can affect ovarian function, ovarian reserve (your number of eggs), sperm quality and quantity, and uterine health.

Chemotherapy and radiotherapy can also cause amenorrhea (loss of period) that is temporary or permanent. It can be hard to predict if this will happen to you, as your outcome depends on factors like age, period regularity before treatment, medications used, and dosages.

The importance of moving fast

Cancer patients often need to make quick decisions about whether to pursue fertility preservation before chemotherapy. In certain cases, treatment may need to start immediately.

But it’s important to note that the best (and often, only) time you will have the option to preserve your fertility is before you begin treatment. If time allows, speak with a fertility specialist about your options so you can make an informed decision. When it feels like there’s so much out of your control, it can be empowering to take this part of the journey into your own hands.

Fertility preservation before reproductive surgery

Surgery to reproductive organs (such as the uterus, ovaries, fallopian tubes, testicles, and prostate) can also affect your ability to conceive.

Surgeries that impact these organs include:

Endometriosis surgery
Vasectomy*
Hysterectomy (removal of the uterus)
Surgery to remove ovarian cysts

*While vasectomies can be reversed, the rate of success for sperm return goes down as more years pass since the vasectomy. Freezing sperm before the vasectomy is a proactive way to safeguard your fertility.

Sometimes, these surgeries may be medically necessary to treat or prevent recurrence of a condition like ovarian cancer. Even if your surgery will prevent you from conceiving naturally, you may be able to retain the ability to conceive with intervention or the option to have a child through a gestational carrier. Always ask your doctor about your options.

Other medical reasons for fertility preservation

There are a range of other conditions and treatments that can necessitate fertility preservation.

For example:

Systemic diseases: Autoimmune diseases and endocrine disorders can cause hormonal imbalances and menstrual irregularities.
Genetic disorders: Conditions such as Turner syndrome and sickle cell anemia impact fertility.
Medications: Some drugs impact the ability to conceive, while others can make it unsafe for women to carry a pregnancy. In those cases, egg freezing and IVF or surrogacy can preserve the ability to have a child.
Hormone replacement therapy (HRT): HRT can treat menopause symptoms, osteoporosis, and other conditions, such as primary ovarian insufficiency. People who are transitioning genders may also take gender-affirming hormone therapy. Preserving fertility before HRT is an important consideration for patients who may want children one day.

Related: Learn more about causes of infertility in women and in men.

Options for medically necessary fertility preservation

Read about fertility options for cancer patients, people undergoing reproductive surgeries, and others who want to protect their ability to conceive for any reason.

Egg freezing for medical reasons

Egg freezing, or oocyte cryopreservation, involves stimulating the eggs to grow, retrieving them during a minimally-invasive procedure, and storage them in a laboratory for future use.

Cycles involve frequent monitoring and medication administration over the course of 2-3 weeks. Egg freezing is often recommended for cancer patients who are of reproductive age and have a regular menstruation cycle.

Embryo freezing

Embryo cryopreservation follows the same process of egg freezing up until the point of cryopreservation. In this process, the eggs are fertilized with sperm to create embryos before being frozen.

Curious about the differences between egg and embryo freezing, and which might be right for you? Learn more about the differences.

Sperm freezing

Freezing sperm before chemo, vasectomy, or another procedure is a simple and efficient fertility preservation option for men.

Sperm freezing involves:

Semen analysis (of sperm count and quality)
Infectious disease testing
Collection of the semen sample
Cryopreservation
Storage in a laboratory facility

Additional options

Egg, embryo, and sperm freezing are not the only options for fertility preservation. Other options like ovarian tissue preservation and GnRh agonist therapy (which suppresses hormone production during a set period of time) are improving fertility outcomes for people with cancer and other conditions.

A fertility specialist will be able to walk you through each of your options and make recommendations based on your unique situation.

Does insurance cover egg and embryo freezing?

Fertility preservation might feel inaccessible as an out-of-pocket expense. But note that some insurances cover egg freezing for cancer patients and people with other medical conditions that adversely impact fertility.

Coverage varies by state and plan. Sometimes, insurance plans cover the egg retrieval procedure, but not the medications, lab costs, or storage fees. Call your insurance company to understand how your benefits apply.

Some insurance companies assign a case manager with a medical background for cancer patients. This person can help you get needed answers about your coverage.

You don’t need to navigate this alone

This probably feels like a turbulent time. It’s overwhelming to face medical treatments and fertility concerns all while grappling with a new, life-changing diagnosis. But you aren’t alone — fertility clinics exist to support people going through some of the hardest times in life.

Fertility preservation gives you the power of choice, and the relief that one part of the process is being taken care of. You will never regret getting the information you need to make an informed decision about your care.

We’re here to walk you through this leg of your journey, so you can concentrate on your treatment. Request a consultation with Dr. Lina Akopians to learn about all of your options and get a tailored fertility plan.

Fertility Preservation Before Cancer Treatment and Medical Procedures