Bottom Line Up Front
Fertility preservation should happen before cancer treatment begins — chemotherapy and radiation can permanently damage eggs and sperm. Rapid-start protocols allow egg freezing to begin any day of the menstrual cycle, and the entire process can be completed in 10–14 days. Sperm banking is even faster (same-day). Time is critical, but options exist.
Why Timing Is Everything
Many chemotherapy drugs are gonadotoxic — they damage the ovaries and testes. Alkylating agents (cyclophosphamide, ifosfamide) carry the highest risk. Radiation to the pelvic area directly damages reproductive organs. The degree of damage depends on drug type, dosage, patient age, and baseline ovarian reserve. For some patients, fertility recovers after treatment; for others, the damage is permanent. The problem: you can't predict which outcome you'll have.
This is why ASCO (American Society of Clinical Oncology) guidelines recommend discussing fertility preservation with every patient of reproductive age before starting treatment, regardless of cancer type.
Options for Women and People with Ovaries
Egg Freezing (Oocyte Cryopreservation)
The most established option. Rapid-start ovarian stimulation protocols can begin any day of the menstrual cycle (you don't need to wait for a period). Injectable fertility medications grow multiple follicles over 10–14 days, followed by a 15-minute egg retrieval under sedation. Eggs are vitrified (flash-frozen) and stored indefinitely.
Success rates depend on the number and quality of eggs retrieved — which correlates strongly with age. Women under 35 who freeze 15–20 eggs have a high cumulative probability of a future live birth from those eggs.
Embryo Freezing
If you have a partner or wish to use donor sperm, fertilizing eggs before freezing creates embryos, which have a slightly higher survival rate after thaw than unfertilized eggs. The stimulation timeline is identical to egg freezing. Embryos can be stored indefinitely.
Ovarian Tissue Cryopreservation
For patients who cannot delay treatment for even 10–14 days (or for prepubertal girls), ovarian tissue cryopreservation is an option. A small piece of ovarian cortex is surgically removed and frozen. After cancer treatment, the tissue can be transplanted back, potentially restoring both fertility and hormonal function. This technique has resulted in over 200 live births worldwide and is no longer classified as experimental by ASRM (as of 2019).
Options for Men and People with Testes
Sperm banking is simple, fast, and accessible. One or more ejaculated samples are collected, analyzed, and cryopreserved. The entire process can happen in a single clinic visit. Multiple samples (2–3) provide more options for future treatment. Even patients with very low counts may benefit from banking — a single viable sperm is sufficient for ICSI.
Financial Assistance
Fertility preservation can cost $5,000–$15,000 for egg/embryo freezing (plus annual storage). Several programs help offset costs:
- LIVESTRONG Fertility: discounted medications and cycle costs at participating clinics
- Walgreens Heartbeat Program: reduced medication pricing
- Team Maggie: grants specifically for cancer-related fertility preservation
- Some insurance plans: an increasing number of states mandate fertility preservation coverage for iatrogenic (treatment-caused) infertility
Time-Sensitive Action
If you've been diagnosed with cancer and haven't discussed fertility preservation, ask your oncologist for a referral to a reproductive endocrinologist today. Most fertility clinics expedite appointments for cancer patients — some offer next-day consultations.
International Options for Fertility Preservation
Some patients choose to preserve fertility abroad for cost savings. Colombian clinics offer egg and embryo freezing at a fraction of US pricing.
Learn About Preservation Options →