Oncofertility

Oncofertility is a medical discipline aimed at preserving the fertility of cancer patients before they begin potentially sterilizing treatments.

Why consider fertility before starting cancer treatment?

Certain cancer treatments, known as gonadotoxic therapies, can damage the ovaries or testes, leading to a reduction or complete loss of fertility.

• In girls and young women: This can cause premature ovarian insufficiency (POI).
• In boys and young women: This can permanently impair sperm production.

Therefore, it is essential to address this issue as soon as diagnosis is confirmed, even when treating the disease is urgent. Timely consultation often helps preserve the chances of having a child in the future.

The Oncofertility Care Pathway at H.U.B

• Cancer diagnosis received
• Referral to the oncofertility team (by the general practitioner, oncologist, hematologist, pediatrician, etc.)
• Rapid consultation with our specialized team
• Assessment of current fertility and treatment-related risks
• Discussion of available options
• Implementation of preservation techniques
• Personalized follow-up after treatment

At the Brussels University Hospital, a dedicated oncofertility team supports patients throughout their care pathway:

• Fertility and reproductive specialists (Brussels University Hospital Fertility Clinic)
• Lead oncologists and hematologists
• Endocrinologists
• Psychologists
• Clinical nurse coordinators
• Reproductive biologists

We work in close collaboration with the oncology teams at the Jules Bordet Institute and the pediatric teams at the Queen Fabiola Children's University Hospital (HUDERF) to ensure therapeutic priorities are respected while integrating fertility preservation whenever possible.

Our specialists

For Girls / Young Women

1. Oocyte Cryopreservation (Egg Freezing)

• Target Audience: Post-pubertal young women (who have started their periods).
• Procedure: Following hormonal stimulation lasting approximately ten days (similar to an in vitro fertilization protocol), the ovaries produce multiple oocytes. These are then retrieved via ultrasound-guided needle aspiration under light anesthesia and subsequently cryopreserved.
• Feasibility: Possible if the initiation of cancer treatment can be deferred by 2 to 3 weeks.

2. Embryo Cryopreservation

• Target Audience: Of-age young women in a stable relationship or with a partner, wishing to create embryos.
• Procedure: Following ovarian stimulation, the retrieved oocytes are fertilized with the partner's (or a donor's) sperm to create embryos, which are then cryopreserved.
• Key Consideration: Requires a clearly defined, mutual parental project.

3. Ovarian Tissue Cryopreservation

• Target Audience: Pre-pubertal girls or young women for whom hormonal stimulation is contraindicated or not feasible.
• Procedure: A minor surgical procedure (typically laparoscopy) is performed to biopsy or remove part of an ovary. This tissue is then cryopreserved. It can later be autotransplanted to restore natural ovarian function or enable pregnancy.
• Advantage: Can be performed on very short notice, without waiting for the menstrual cycle.

4. Ovarian Suppression During Chemotherapy

• Target Audience: Post-pubertal young women.
• Procedure: Medications known as GnRH agonists (Gonadotropin-Releasing Hormone analogues) are administered to induce a temporary medical menopause, effectively putting the ovaries "at rest" during treatment. This is not a standalone fertility preservation method but can help mitigate gonadotoxic damage.
• Limitations: Less effective than cryopreservation techniques, but serves as a useful adjuvant therapy.

For Boys / Young Men

1. Sperm Cryopreservation (Semen Banking)

• Target Audience: Post-pubertal young men.
• Procedure: Prior to commencing treatment, one or more semen samples are collected (via masturbation) and subsequently cryopreserved.
• Advantage: Simple, rapid, and non-invasive. Cryopreserved sperm can be stored long-term for several years.

2. Testicular Tissue Cryopreservation

• Target Audience: Pre-pubertal boys (who do not yet produce mature spermatozoa).
• Procedure: A minor surgical biopsy is performed to extract a small piece of testicular tissue containing spermatogonial stem cells. This tissue is then cryopreserved for future clinical use.
• Current Status: This method is currently classified as experimental but holds significant promise, particularly for very young patients.

Selecting the Appropriate Option

The clinical decision depends on several variables:

• The patient’s age and pubertal status
• The specific diagnosis and type of cancer
• The clinical urgency to initiate oncological treatment
• The preferences and wishes of the child/adolescent and their family
• Potential medical contraindications

Our multidisciplinary team is here to support you at every stage, explaining the available options, answering your questions, and coordinating care to ensure the timeliest management possible.

Are you about to start a potentially gonadotoxic treatment? Are you unsure whether your treatment could impact your fertility?

Contact our Oncofertility specialists by phone without delay!

To arrange a sperm cryopreservation for a patient, please contact us by phone at +32(0)2 555 31 95.

For any additional, non-urgent inquiries, you can contact us by email at Oncofertilite [dot] FIV [at] hubruxelles [dot] be (Oncofertilite[dot]FIV[at]hubruxelles[dot]be.)