BOBÌåÓý

Cancer is never part of the plan, nor is giving up the dream of having children.

BOBÌåÓý’s Oncofertility Program empowers patients with cancer to take control of their future by preserving their fertility.

The BOBÌåÓý Oncofertility Program, also known as the Helping Oncofertility Patients become Educated (HOPE) Network, aims to help oncology patients of reproductive age or prepuberty understand their options for preserving fertility. Cancer treatments, though they can be lifesaving, may cause infertility. For women, they can lead to damaged ovaries or reduced egg production. For men, the treatments may damage testicular tissue and disrupt sperm production.

The HOPE Network, directed by Alice Rhoton-Vlasak, MD, is centered on patient education. “Ideally, 100% of patients with cancer or people who could be future parents are aware of what their options are for preserving fertility,� she said. “While not all patients will choose to undergo fertility preservation treatments, knowing that this is an option for them is the goal of the program.�

Multiple fertility preservation measures � such as hormone therapy and egg, sperm or embryo freezing � are all used in the program. Another key feature is the opportunity for inpatient and outpatient care. Patients undergoing treatment for a variety of cancers, whether it’s leukemia, sarcomas or lymphoma, can undergo fertility preservation treatment without leaving their hospital room.

The multifaceted HOPE Network involves physicians, nurse navigators, psychologists and others. The team ensures that patients receive comprehensive support, enabling them to make well-informed decisions about their care and fertility options.

“There’s a lot of information that’s going in every direction when these patients are undergoing treatments, surgeries and chemotherapies,â€� said Kevin Campbell, MD, a BOBÌåÓý reproductive endocrinologist and another key player in the HOPE Network. “Their focus might be one place, on the survivorship, and then afterward on the quality of life. I think having an anchor point where people can tell you things you can do to help yourself in the future is key.â€�

The BOBÌåÓý HOPE Network

Every year, more than 100 women and men are involved in the program combined. These patients vary in age, from “reproduction age down to babyhood,� as Dr. Rhoton-Vlasak says.

Dr. Campbell leads clinical trials targeting the pediatric population. These trials focus on helping young individuals who may lose testicular tissue or undergo intense chemotherapy that affects sperm production.

“Currently, a young male does not really have many options for fertility preservation if it’s prior to puberty,� he said. “So, what this trial is aimed at is taking some tissue and freezing that for the possibility of maybe using it in the future to restore some of their fertility potential.�

Providing fertility care that targets this pediatric population will help foster a more inclusive and comprehensive program.

Breaking misconceptions and building support

With the uncertainty of a cancer diagnosis, misconceptions about fertility preservation often arise. One of these is that a cancer survivor won’t be able to have children

In fact, Dr. Rhoton-Vlasak said the opposite is true.

“Most studies show that once you’re cancer-free and out of the treatment range, like a couple of years down the road, if everything is OK from your reproductive parts standpoint, then most of the time it’ll be safe to have a pregnancy in the future,� she said.

This was true for two BOBÌåÓý patients, Dollie and Gloria.

Dollie’s story

After struggling with infertility, Dollie turned to BOBÌåÓý for an answer. Unfortunately, her answer lay in a precancer diagnosis. Dollie was diagnosed with endometrial intraepithelial neoplasia, or EIN. EIN is often considered a precursor to endometrial cancer, or cancer in the uterine lining.

Upon her diagnosis, Dollie immediately thought back to what brought her to BOBÌåÓý in the first place: her ability to have children. She would not let cancer prevent her lifelong dream of becoming a mother

“I knew I wanted a child, and I refused to give up. Until I tried everything, I refused to give up,â€� Dollie said. Luckily for Dollie, Dr. Rhoton-Vlasak and the rest of the team at BOBÌåÓý Reproductive Medicine made giving up not an option. Living in Gainesville and working at BOBÌåÓý Shands Hospital cemented Dollie’s decision to trust Dr. Rhoton-Vlasak and the team for her care.

Dr. Rhoton-Vlasak and the team decided that the best option for Dollie would be intrauterine insemination, or IUI. This treatment involves preparing a semen sample in the laboratory and then using a soft, thin, flexible plastic catheter to gently pass through the cervix and deliver the processed sperm directly into the uterine cavity. IUI is administered in rounds, determined by a woman’s menstrual cycle. IUI is typically done before doctors try other fertility treatment options like in vitro fertilization, or IVF.

After five unsuccessful rounds of IUI, Dollie received devastating news: Her cancer had returned. Because of this, Dollie had to pause her fertility treatment attempts.

A year later, Dollie was strong enough to try one final round of IUI. Given her medical history, her doctors had set strict limits. Dollie was now on her sixth and final attempt. This last attempt wasn’t just another procedure; it was her final shot at the family she had longed for.

After her sixth and final round of IUI, Dollie became pregnant with what Dr. Rhoton-Vlasak referred to as her “miracle baby.� Adeline is now 6 months old and serves as a reminder to Dollie of her perseverance.

“All the struggle, all the heartbreak, all the financial strife, all the difficulties are all worth it,â€� Dollie said. “I can’t speak highly enough about BOBÌåÓý, and I’m very grateful because I would not have my daughter if it weren’t for them.â€�

Gloria’s story

Gloria was diagnosed with ductal carcinoma in situ, or DCIS, an early-stage breast cancer that usually does not spread to surrounding tissues, which was true for Gloria. Immediately after her diagnosis, Gloria was advised that she could harvest her eggs in case her DCIS treatment interfered with her fertility.

Gloria then began IVF treatment. IVF is a multistep process that involves collecting eggs and fertilizing them with sperm in a lab. These fertilized eggs, known as embryos, are then placed in the uterus. These embryos were created and then frozen for the entirety of Gloria’s cancer treatment. Five years after her treatment, Gloria was fully cleared to begin IVF treatment.

“We had only two good embryos,� Gloria said. “So, two shots. Knowing that she could probably not get pregnant without assisted reproductive technology, Gloria was determined to make one of these embryos work. Unfortunately, her first embryo resulted in an early miscarriage.

After navigating what could have gone wrong with the first embryo, Maribeth Williams, MD, MS, and Dr. Rhoton-Vlasak decided to try intracytoplasmic sperm injection, or ICSI. This technique involves a single, healthy sperm injected directly into the egg’s cytoplasm using a micropipette. Unlike IVF, the injection involves just one sperm and multiple eggs, while IVF uses multiple eggs and sperm.

ICSI was successful for Gloria, leading to a pregnancy. Gloria, thrilled to be a mother, prepared for her son to enter the world. Although she was under the impression she could not conceive naturally, a little over a year later, Gloria unexpectedly became pregnant with her daughter.

Now a busy mom with “two under two� � her way of describing the small age gap between her children � Gloria hopes to inspire others facing similar challenges

“You just never expect this to happen to you this young, but you can either let it break you or you can push forward,� she said. “Eventually, you may have the life that you wanted, that you didn’t think was possible after your diagnosis.�

Gloria is now living the life she always dreamed of, thanks to her care team at BOBÌåÓý.

“There’s something really kind of intangible but important about the support that you feel from your doctor,� she said. “Not that that would make a huge difference in whether your body is going to get pregnant necessarily, but it feels like it made a difference."

Getting involved with the HOPE Program

The BOBÌåÓý HOPE Program functions as a comprehensive network that spans multiple departments across the BOBÌåÓý system. It continues to expand through ongoing research projects, educational initiatives and external funding.

Recognizing the high cost of fertility treatments, the HOPE Program has received grant funding from various sources, including , the Pruitt Family Foundation and the . Among these, the Climb for Cancer Foundation � founded by Ron and Dianne Farb � has played a crucial role in supporting patients by covering practical expenses related to cancer treatment, such as gas cards, meal vouchers and meeting costs.

Schedule an appointment or read more about BOBÌåÓý’s Reproductive Medicine.