Bob Underwood, M.D. (Host) [00:00:00] A cancer diagnosis means patients have a lot of important decisions to make before beginning their treatment plan. Decisions about preserving fertility should be part of the early conversations with your oncologist. Joining us now to explain the significance of onco fertility is reproductive endocrinologist and infertility specialist Dr. Laurie McKenzie. Dr. McKenzie, welcome to the Cancerwise podcast. 

Laurie McKenzie, M.D. [00:00:33] Great. Well, thanks for having me. I'm really happy to be here today. So thanks for the invitation. 

Bob Underwood, M.D. (Host) [00:00:39] Yeah, absolutely. This is a great topic for us to discuss. So, let's start with what is oncofertility. 

Laurie McKenzie, M.D. [00:00:47] Absolutely. So, onchofertility is a fairly new subspecialty of medicine that actually bridges oncology and reproductive endocrinology and fertility. And the goal is for us to expand the options for future childbearing for those affected by cancer. 

Bob Underwood, M.D. (Host) [00:01:09] So, why is oncofertility so important to discuss? 

Laurie McKenzie, M.D. [00:01:15] It's becoming more and more important and so, I'm glad you asked that question. About 10% of those diagnosed with cancer now in the United States are of reproductive age. And the good news is, the vast majority of these individuals are going to survive their cancers and lead, long, healthy lives. And for many of these individuals, having a family is part of that life journey. And so that's what we are here to support for them. 

Bob Underwood, M.D. (Host) [00:01:47] And I think that that's a great position that MD Anderson has. It's the whole person care and that's part of that survivorship, I think. So, what are some options that patients do have to protect their fertility. 

Laurie McKenzie, M.D. [00:02:04] Well, there's quite a few options that exist today that didn't exist years ago. We have the option of sperm cryopreservation, embryo or egg freezing, ovarian tissue cryopreservation. And these are all considered non-experimental and standard of care therapies. We also have the option of utilizing for women a medication that may help quiet down the ovaries or put them, you know, the ovaries in a, in a quiescent state during chemotherapy, which may actually allow the ovaries to recover better after chemotherapy. So, the good news is there are several options now available for patients. And so important to have these discussions prior to starting chemotherapy or other cancer therapies. 

Bob Underwood, M.D. (Host) [00:02:58] That's an amazing advantage. And so, so I understand there may be some myths about oncofertility out there. Can you clue us in on some of those?

 Laurie McKenzie, M.D. [00:03:08] Absolutely. I think one of the biggest myths is that someone would not be able to have a child. So a lot of the work that I do in my partners do is to try to dispel, that myth in and of itself. I think another common myth is just that the ovaries and the sperm production will not recover post chemotherapy, which, fortunately for many young patients, their fertility does recover. So, I think it's really important to be able to counsel patients about that and to offer them ways to track fertility after they're finished with their treatment. 

Bob Underwood, M.D. (Host) [00:03:49] So, what are questions that patients should specifically ask their doctor after a new cancer diagnosis? 

Laurie McKenzie, M.D. [00:03:57] I think one of the most important, questions to ask is if there is access to a reproductive endocrinologist, either at their specific facility or in their local, area that they could meet with and talk about some of these important options regarding fertility preservation. As I mentioned, there are ways to also track fertility, after cancer therapy is completed. And so, to have some of those fertility assessments before cancer therapy begins is really helpful, because then you can have a before and after to compare what is that fertility function now after cancer has been, cancer treatment has been completed. 

Bob Underwood, M.D. (Host) [00:04:43] Right. So, it's important to have those conversations with your doctor right away. 

Laurie McKenzie, M.D. [00:04:48] Yeah. I think time is of the essence. Many of these options are not considered viable options once treatment has already started. So very important, to have that discussion about banking sperm or eggs versus embryos before cancer therapy starts. If time is not available to undergo egg or embryo banking, ovarian tissue cryopreservation can be expedited, before chemotherapy starts. So, some of the timing of these options can also be discussed with their reproductive endocrinologist or infertility specialist. 

Bob Underwood, M.D. (Host) [00:05:31] Sure, sure. Important to do that. So, what other resources are available to try to help? 

Laurie McKenzie, M.D. [00:05:37] Well, fortunately, there's a lot of resources that are available online. And more and more states are offering coverage for fertility preservation options, through their insurer private insurance plans. There are several nonprofit organizations that can help, facilitate coverage of medications or coverage for egg freezing, for example. 

Bob Underwood, M.D. (Host) [00:06:04] That's great. And it's great that, you know, they have access to to experts like you on subjects like this. This is wonderful information. So, what's next for oncofertility? What is your research focus? 

Laurie McKenzie, M.D. [00:06:20] So, my research focuses on how does, do some of these newer cancer therapies, impact fertility? Fortunately, there has been a significant increase in options for cancer therapy, including immunotherapies, for example, and we know so little. How do these therapies impact fertility for men and women? And my research is focused on exploring that, to be able to counsel patients better in terms of what to expect post-cancer therapy in terms of their fertility. 

Bob Underwood, M.D. (Host) [00:06:58] Wow. Dr. McKenzie, thank you for sharing your expertise with us today. 

Laurie McKenzie, M.D. [00:07:03] Absolutely. Well, thanks for having me. And, just happy to be here. Thank you. 

Bob Underwood, M.D. (Host) [00:07:08] Great information. For more information or to request an appointment at MD Anderson, call 1-877-632-6789 or visit MDAnderson.org. I'm Dr. Bob Underwood. Thanks for listening to the Cancerwise podcast from MD Anderson Cancer Center.