n EFFECTS OF SURGERY ON FEMALE REPRODUCTION Because of the proximity of the bladder to the female pelvic organs, girls who have had pelvic surgery, including cystectomy (bladder surgery), may expe- rience sexual problems like a change, decrease, or loss of sensation to the vagina or painful
intercourse. Removing one or both ovaries as part of treatment will affect fertility as well. If both ovaries are removed, she will experience menopause symptoms without replacement of hormones. If her uterus is removed for cancer treatment, she will be unable to carry a pregnancy but still may be able to have a child via a gestiational carrier (surrogate) if her ovaries are spared. Neurosurgery or surgery near the spinal cord may also cause sexual problems in females by damaging the nerves near the ovaries and uterus. This may result in a change, decrease, or loss of sensation to the vagina, or painful intercourse. n OPTIONS FOR SAVING FERTILITY AT THE TIME OF TREATMENT There are many options for saving fertility in children diagnosed with cancer, but the use of each option will depend on your child’s age, the severity of disease at the time of diagnosis, additional medical concerns, and cost. Insurance may not cover any expenses for experimental treatments to save fertility. The barriers to fertility preser- vation include the need to begin cancer treatment immediately, the cost, obtaining consent during a stressful time, as well as ethical and cultural issues. Some options for fertility preservation, such as egg harvesting and freezing, have been performed for decades and are not experimental, though there may be research or experimental options available to your child. Experimental means that the safety of the treatment is not known, either because no pregnancies in humans have occurred as a result of the treatment, or there have not been enough pregnancies to under- stand the long-term effects of the fertility preservation technique.
6
Powered by FlippingBook