Surgery is sometimes required to treat conditions associated with infertility, such as endometriosis and uterine fibroids. Today, most surgical treatments for infertility are performed on an outpatient basis with minimally invasive techniques such as laparoscopy and hysteroscopy. These services are available at several locations for patient convenience.
Cleveland Clinic infertility physicians are internationally recognized for their expertise in laparoscopic treatment and were the first physicians in the world to perform a totally robotic surgery. Today, with either robotic or laparoscopic techniques, we offer:
- Treatment of endometriosis including very advanced stages of disease
- Removal of fibroids
- Removal of adhesions (scar tissue)
- Reversal of tubal ligation
- Opening blocked tubes
- Repair of uterine malformations
A cancer diagnosis may not immediately lead to thoughts about one's fertility. But, if you're a woman of childbearing age or a man who is concerned about his future ability to become a father, it is important to understand that the treatments that help fight cancer may also affect your ability to have children.
Cleveland Clinic fertility specialists offer several options to preserving your fertility.
Download a booklet that provides information on infertility risks, fertility preservation options and parenting options after cancer.
To better serve patients considering chemotherapy or other treatments that may be harmful to future fertility, Cleveland Clinic provides several options for fertility preservation. Our fertility specialists work closely with the Taussig Cancer Institute as well as cancer centers nationally to offer a variety of methods to preserve your fertility.
Options that are currently available for women at the Fertility Center include:
- Egg freezing
- Embryo freezing
- Ovarian tissue freezing
- Fertility preserving surgery
- Suppressing ovarian activity during chemotherapy
Options that are currently available for men at the Fertility Center include:
- Sperm banking
- Testicular tissue freezing
How do I know whether fertility preservation is right for me or which option to choose?
When a cancer diagnosis is made, same day or next day appointments are available with Cleveland Clinic fertility specialists to discuss which technique may best fit your situation. Call 216-839-3150 to arrange your visit. Fertility preservation works best if initiated prior to starting cancer treatments. Some of the factors that go into making decisions about fertility preservation include:
- Dose, type, and duration of treatments (in general, the higher the dose and the longer the treatment, the greater the chance for developing fertility problems)
- The area receiving radiation (if used)
- When treatments are set to begin
- Marital status
- Personal, cultural, or religious beliefs
What is involved in each of the available options for fertility preservation?
Embryo freezing: Embryo freezing is the best studied and most widely used form of fertility preservation. Embryos are obtained through an advanced fertility treatment called in vitro fertilization (IVF). IVF has resulted in millions of live births in women and men with infertility. The ovaries are stimulated with injections of hormones which stimulate follicles on the ovaries to produce mature eggs. The process is closely monitored during 1-2 weeks of ultrasounds and blood draws. Once the eggs are mature, the egg retrieval procedure is performed using an ultrasound-guided needle while you are asleep under anesthesia. The process takes about 20 minutes. Eggs are fertilized with sperm and fertilized embryos are frozen for later use. Cancer treatments can begin shortly after the egg retrieval.
Egg freezing: The process is the same as for embryo freezing, however eggs are frozen and are not fertilized with sperm. These eggs can then be thawed and fertilized in the future if and when they are needed. Egg freezing is a newer technology, but it is no longer considered experimental and may be an ideal option for young women, women without a partner, or patients who have personal concerns about embryo freezing.
Ovarian tissue freezing: This technology is offered at Cleveland Clinic under an experimental protocol. Ovarian tissue freezing is an option for women who can not wait 2-6 weeks to begin their cancer treatments or for women who cannot undergo hormonal stimulation. Ovarian tissue is surgically removed through a minimally invasive procedure and frozen until chemotherapy and/or radiation therapy is completed. The thawed tissue can then be re-implanted into the pelvis. It may then regain function well enough to release an egg and allow for “natural” pregnancy. Eggs from the transplanted tissue may also be removed for in vitro fertilization.
What questions should I ask at my visit?
Thinking about fertility before cancer treatment begins is important. The following questions will be helpful when talking to the medical team about the effects of cancer treatment on fertility.
- Will cancer treatment have any short- or long-term side effects on my reproductive system?
- Is infertility a possible side effect of treatment?
- Are there alternative ways to treat this cancer that reduce the risks of damage to my reproductive system?
- What are my options for preserving fertility before, during and after treatment?
- Would any of these options make my treatment less effective?
- After treatment, how will I know if I am infertile or fertile?
- If treatment results in infertility, what are my options for becoming a parent?
- How long after treatment should I wait before trying to conceive?
Questions for women
- Will I enter premature menopause after treatment?
- If I become menopausal after treatment, is it likely to be temporary or permanent?
I have more questions – who can I call?
Call 216.839.3150 to speak with a member of our team of fertility specialists. For after hours calls, ask to be connected to the fertility specialist on call.
- Fertile Hope
Fertile Hope is a national LIVESTRONG initiative dedicated to providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility.
- Fertile Action
Fertile Action helps women touched by cancer become mothers through education, advocacy and financial aid for fertility preservation, sperm donation, egg donation, surrogacy and long-term storage of sperm, oocytes, and embryos.
- American Cancer Society
The American Cancer Society is a nationwide, community-based voluntary health organization dedicated to eliminating cancer as a major health problem.
Cancer.net brings the expertise and resources of ASCO (American Society of Clinical Oncology) to people living with cancer and those who care for and care about them.
- National Cancer Institute
The National Cancer Institute (NCI) is the Federal Government's principal agency for cancer research and training.
- Cancer Support Community
To ensure that all people impacted by cancer are empowered by knowledge, strengthened by action, and sustained by community.
- The Wellness Community
The Wellness Community is an international non-profit organization dedicated to providing free support, education and hope to people with cancer and their loved ones.
- Stupid Cancer: The voice of young adult cancer
Stupid Cancer proudly supports a global network of patients, survivors, caregivers, providers and advocates to ensure that no one affected by young adult cancer go unaware of the age-appropriate resources they are entitled to so they can get busy living.
Cleveland Clinic’s fertility team and state-of-the-art fertility lab have been instrumental in developing and advancing novel technologies for fertility. These advancements have assisted in producing some of the highest pregnancy success rates in the country. To view our history of success rates, visit the Society of Assisted Reproductive Technology website.
For a couple struggling with fertility, it is normal to have financial concerns. As reproductive testing and services can be an out of pocket cost, you want to ensure that you choose the best program possible; one that will give you the best chance in helping you build your family. Typically, your insurance plan will cover portions of the treatment, but not all. It is important to address any questions and concerns prior to starting treatment, and understand all that fertility treatment entails. Couples should be aware that some In Vitro Fertilization (IVF) programs advertise a low fee for IVF, but then tack on many additional charges for things such as follicle monitoring, ICSI, assisted hatching and/or embryo freezing. At Cleveland Clinic, all of our services are included in the fee quote that the financial counselor will share with you.
At Cleveland Clinic, we offer different financing options to help make fertility treatments affordable. We have partnered with Advanced Reproductive Care, Inc., a company that offers various financing options, refund guarantees, and fertility pharmacy plans. We have established partnerships with various employers who offer discounts to their employees for fertility treatments. We also have the Harboring Hope® fund which is a program that assists couples who meet specific clinical and financial requirements to apply for significant funding for a subsequent IVF cycle.
Prior to starting your fertility treatment, you will meet with one of our financial counselors to go over what your insurance covers and what financial obligations you will have. For more information, please call 216.839.3150 and select option 5.