Course / The Risks of Infertility & Other Possible Risks
Even in the absence of cancer, fertility naturally declines over time, particularly in women.
Key factors include:
Age-related decline in oocyte quantity and quality
Ovarian reserve diminishes with age, and the risk of chromosomal abnormalities increases.
Environmental and lifestyle exposures
Smoking, obesity, extreme stress, or exposure to toxins can reduce fertility in both sexes.
Idiopathic infertility
Approximately 10–15% of couples experience unexplained infertility despite normal test results.
For male fertility, advancing age and oxidative stress may reduce sperm motility and DNA integrity.
Thus, pre-treatment fertility preservation should be considered within this broader biological context, not only as a cancer-related concern.
Gonadotoxic Effects of Cancer Therapy
Most cancer treatments are designed to target rapidly dividing cells. Unfortunately, gametes and germline stem cells fall into this category.
Chemotherapy (especially alkylating agents like cyclophosphamide) can cause irreversible ovarian or testicular failure.
Radiation therapy, particularly pelvic or cranial irradiation, can impair gonadal and hypothalamic-pituitary function.
Surgery, such as oophorectomy or testicular removal, results in direct loss of reproductive capacity.
Timing and Age Sensitivity
Younger patients have greater regenerative potential, but even short courses of cytotoxic therapy can cause long-term impairment.
Preservation prior to initiating therapy remains the most effective preventive measure.
Medical and Obstetric Risks
Following cancer remission, some patients may face increased risks during pregnancy:
Cardiopulmonary compromise in those exposed to anthracyclines or chest radiation.
Uterine vascular or endometrial damage leading to growth restriction or preterm labor.
Hormone-sensitive malignancies (e.g., breast cancer) may pose recurrence risks if estrogen levels rise during gestation.
Role of Gestational Surrogacy
For individuals whose prior treatments have rendered pregnancy unsafe or medically contraindicated, gestational surrogacy provides a safe and effective pathway to biological parenthood.
Surrogacy4All specializes in pairing cancer survivors with medically cleared gestational carriers to ensure optimal maternal-fetal outcomes.
Genetic and Epigenetic Concerns
While most cancers are sporadic, certain malignancies (e.g., BRCA1/2, Lynch syndrome) have heritable components.
Fertility specialists recommend:
Genetic counseling prior to conception or embryo creation.
Preimplantation genetic testing (PGT-M) to identify and prevent the transmission of known pathogenic variants.
Long-Term Offspring Outcomes
Current data indicate that children born to cancer survivors do not have higher rates of congenital anomalies when conception occurs after completion of therapy and appropriate recovery time.
However, early conception post-treatment may carry increased risk due to residual cytotoxic exposure.
Ovarian Stimulation and Retrieval
Although generally safe, ovarian stimulation involves potential complications:
Ovarian Hyperstimulation Syndrome (OHSS): Fluid accumulation, electrolyte imbalance, and discomfort from exaggerated ovarian response.
Procedure-related risks: Bleeding, infection, or anesthetic reactions during egg retrieval.
Hormonal implications: For estrogen-sensitive cancers, stimulation protocols must be modified (e.g., letrozole-based or antagonist cycles) to minimize hormonal exposure.
Laboratory and Cryostorage Risks
Modern vitrification techniques yield >90% survival for oocytes and embryos, yet risk of lab error, equipment failure, or storage compromise—though rare—must be mitigated through strict quality control protocols and dual monitoring systems.
Multiple gestations can result from transferring more than one embryo during IVF.
While this may increase pregnancy rates per transfer, it also significantly raises maternal and neonatal risks:
Preterm birth and low birth weight
Gestational hypertension and preeclampsia
Cesarean delivery and postpartum hemorrhage
Current best practice—endorsed by the American Society for Reproductive Medicine (ASRM)—advocates single embryo transfer (SET) to optimize safety and neonatal outcomes.
At Surrogacy4All, all affiliated clinics follow strict embryo transfer guidelines to prevent avoidable multiple pregnancies.
Baseline Risk
All pregnancies carry a 2–3% background risk of congenital anomalies, regardless of fertility treatment.
Extensive global data indicate that assisted reproductive technologies (ART), including IVF and ICSI, do not substantially increase this risk when modern laboratory and culture standards are followed.
IVF-Specific Considerations
Some studies show a slight increase in imprinting disorders (e.g., Beckwith-Wiedemann syndrome), but absolute risk remains extremely low (<0.01%).
Embryo culture duration, media composition, and cryopreservation protocols are continually refined to minimize these effects.
Post-Treatment Reassurance
When fertility preservation and ART are conducted under expert supervision with evidence-based protocols, the safety of offspring is comparable to naturally conceived pregnancies.
Our job is to listen, to connect the dots between your needs, and to determine how we can best help you have your baby. If you’re asking how much does it cost for a surrogate, we’ll walk you through every step of the process to ensure there are no surprises.
To make an appointment with one of our counselors or physicians, please call (212) 661-7673 or email info@surrogacy4all.com. We look forward to hearing from you.
Surrogacy4All is a unique international surrogacy service targeted at providing state of the art IVF and surrogacy services to Intended Parents irrespective of age, sex or color, at the lowest possible cost in the world.
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