• Pediatric Fertility Preservation Program

    At Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, we value the importance of fertility and reproductive health as it relates to long-term quality of life. As treatment for childhood cancers and blood disorders have improved, more and more survivors are entering their reproductive years and thinking about starting families of their own. Since some of the treatments we use to fight disease can affect or harm fertility, we are committed to meeting each new patient before the start of treatment.

    The fertility preservation team will work closely with patients’ primary care team to ensure that a fertility consultation takes place as a part of the patient’s comprehensive work-up. The fertility consult includes:

    • education about reproductive health
    • counseling about the patient’s individualized risk of infertility based on the proposed treatment regimen
    • information about the available options for fertility preservation
    • information on the financial implications of these interventions

    If fertility preservation is desired, we will facilitate next steps to make sure that all needs are met in a timely manner.

    Options for Males

    Sperm banking

    Sperm banking is offered to all eligible male patients who have undergone puberty (typically 13 years old or more). Adolescents who are capable of producing a semen sample by self-stimulation can have the sample preserved for future use.

    This is recommended for boys who will receive therapy that has a chance of causing permanent damage to sperm production.

    Testicular sperm extraction and banking

    All eligible male patients who have undergone puberty but are unable to produce a semen sample may also preserve sperm. A surgical biopsy of the testicle is performed to obtain a sample of tissue from which sperm are produced. The sperm can then be extracted for preservation.

    Testicular tissue banking

    Boys who have not entered puberty do not produce sperm. But, their testicles contain cells that are the precursors for sperm or spermatogonia. These testicular stem cells can be affected by some therapies. Testicular tissue freezing is a preservation option that can be performed before puberty, but it is experimental. In this procedure, small pieces of testicular tissue are surgically removed before cancer treatment and frozen for future use.

    Options for Females

    Oocyte (egg) and embryo freezing

    Ovarian stimulation for the purpose of harvesting and freezing eggs is a well-established way of preserving fertility in post-pubertal females. Because this process often delays the start of treatment, it is not an appropriate option for every patient. When a patient’s primary care team feels this can be safely done, hormonal medication is used to stimulate the formation of multiple follicles in the ovary, which contain eggs. These eggs are then removed in a minor surgical procedure and are frozen for the patient’s potential future use to achieve a pregnancy.

    There have been hundreds of live births from frozen eggs. In a circumstance where the patient has a partner or wishes to use donated sperm, there is also the option of using the eggs to create an embryo, which can also be frozen for future use. Embryo freezing is considered an established method of fertility preservation.

    Ovarian tissue cryopreservation

    Ovarian tissue freezing is available for all ages including young girls that have not yet gone through puberty. The advantage of ovarian tissue freezing is that the procedure can be done quickly and does not require time to stimulate eggs in the ovary with medication. Ovarian tissue freezing also requires a surgical procedure. In this process, doctors surgically remove an entire ovary. The tissue is then processed, frozen, and stored for future use. When the patient wishes to become pregnant, the tissue can be thawed and re-implanted. After transplants, the tissue starts producing hormones and eggs.

    There is also active research in extracting immature eggs from ovarian tissue in the laboratory and maturing them for use in in-vitro fertilization, without re-implanting the tissue. So far, successful pregnancies have only occurred after re-implanting the tissue. However, in the future it may be possible to have a pregnancy without having to have the tissue re-implanted. While ovarian tissue cryopreservation holds a lot of promise, it is still considered experimental.

    Resources

    Livestrong: Becoming a Parent After Cancer: provides information on fertility risks, preservation options, and access to discounts.

    Save My Fertility: provides information for patients and providers about fertility preservation before and during cancer treatment.

    Oncofertility Consortium: a national, interdisciplinary initiative designed to explore the reproductive future of cancer survivors.

    Children’s Oncology Group: guidelines for female health issues and guidelines for male health issues after treatment of childhood cancer.

    Verna’s Purse: financial assistance program available to patients faced with economic challenges to help with the cost of long-term storage of tissue.

    Brigham & Women’s Center for Infertility & Reproductive Surgery: one of the premier infertility and reproductive medicine programs in the country.

    The Care Team

    Our team includes members from the Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Urology at Boston Children's Hospital and Department of Obstetrics and Gynecology at Brigham and Women's Hospital.

    Lindsay Frazier, MD
    Medical Director, Pediatric Fertility Preservation Program
    Dana-Farber/Boston Children's Cancer and Blood Disorders Center

    Katie Brodigan, FNP
    Nurse Practitioner
    Dana-Farber/Boston Children's Cancer and Blood Disorders Center

    Lisa Diller, MD
    Chief Medical Officer
    Dana-Farber/Boston Children's Cancer and Blood Disorders Center

    Kathleen Stiffler, CPNP
    Nurse Practitioner
    Dana-Farber/Boston Children's Cancer and Blood Disorders Center

    Marc Laufer, MD
    Chief, Division of Gynecology
    Co-Director, Center for Young Women's Health
    Boston Children's Hospital

    Lalita Haines, MD
    Associate Clinical Director, Division of Gynecology
    Boston Children's Hospital

    Amanda French, MD
    Division of Gynecology
    Boston Children's Hospital

    Erica Thibeault, PA
    Division of Gynecology
    Boston Children's Hospital

    Elizabeth Ginsburg, MD
    Division of Obstetrics and Gynecology
    Boston Children's Hospital

    Serene Srouji, MD
    Division of Obstetrics and Gynecology, Reproductive Endocrinology
    Brigham & Women’s Hospital

    Richard Yu, MD, PhD
    Urology
    Dana-Farber/Boston Children's Cancer and Blood Disorders Center

    Robert Shamberger, MD
    Chief, Department of Surgery
    Boston Children's Hospital

    Brent Weil, MD
    Department of Surgery
    Boston Children's Hospital

    Christopher Weldon, MD
    Department of Surgery
    Boston Children's Hospital

    Karen Marcus, MD
    Chief, Division of Radiation Oncology
    Boston Children's Hospital

    Karen Wright, MD
    Brain Tumor Center
    Dana-Farber/Boston Children's Cancer and Blood Disorders Center

    Christine Duncan, MD
    Stem Cell Transplant Center
    Dana-Farber/Boston Children's Cancer and Blood Disorders Center

    Angela Feraco, MD, MMSc
    Hematologic Malignancy Center
    Dana-Farber/Boston Children's Cancer and Blood Disorders Center

    Contact Us

    To schedule an appointment or for questions regarding fertility preservation:

    Phone: 617-582-9862

    E-mail: FertilityConsult@dfci.harvard.edu

  • Contact Us

    Our specialized new patient coordinators can answer your questions about treatment options and becoming a patient.
  • Study: Strong Pregnancy Outcomes for Survivors of Childhood Cancer

    Dr. Lisa Diller

    “Most women think that if they had cancer as a child, then they’ll never have children. It turns out that many of them can get pregnant,” reports Lisa Diller, MD, chief medical officer of Dana-Farber/Boston Children’s and senior author of the study.

  • Genetic Testing

    Genetic Testing

    A genetic test can explain why a child or young adult developed cancer and can help predict whether he is at risk for other conditions.