Breast cancer treatment often impacts a woman's ability to become pregnant and this can be difficult news to hear. Research indicates that many breast cancer patients, especially young survivors, are concerned about fertility. Still, many don’t bring it up with their doctors. Whether you had planned to begin a family, continue to grow a family, or have children someday, the best time to begin a discussion about post-treatment fertility concerns is before beginning treatment.
One of the biggest challenges to becoming pregnant after cancer treatment is the time it takes to complete treatment, while a woman’s ovaries are aging, and fertility is decreasing.
If you had been planning to start or add to your family you might want to begin a discussion about post-treatment fertility concerns with your provider before beginning treatment.
Cancer Treatment and Fertility
Many challanges to fertility are present after cancer treatment.
- Chemotherapy can bring on early menopause and, depending on a woman’s age and the length and type of treatment she receives, ovulation and menses (periods) may or may not return. The closer a woman is to 40 when she begins treatment, the less likely it is that her periods will resume.
- Ovarian suppression may be recommended for some breast cancer patients. When ovarian suppression is recommended, it is usually for five years, and prevents pregnancy for that time.
- Oophorectomy (removal of the ovaries) may be recommended if you have a BRCA mutation or high risk of developing ovarian cancer. Oopherectomy causes a permanent loss of fertility.
- Endocrine (hormone) therapy, such as tamoxifen, may be included as part of your treatment; this also requires a delay of pregnancy until treatment is complete.
Our experts at the Johns Hopkins Fertility Preservation Center, will consult with your oncologist to evaluate whether you are a candidate for fertility preservation.
What Is Fertility Preservation?
The goal of fertility preservation is implantation of a pregnancy years later, once treatment is complete and a pregnancy is felt to be safe.
- Embryo cryopreservation involves harvesting of eggs, in-vitro fertilization with a partner's (or donors) sperm, and freezing of the fertilized eggs.
- Oocyte cryopreservation, the freezing of unfertilized eggs may be an option for women who do not have a partner, though this method is considered experimental and has a much lower success rate than embryo cryopreservation.
- Our partnership with Fertile Hope's Sharing Hope Program for Women can offer some financial assistance to offset the cost of these procedures.
Our nurse navigator can help set you up with a consultation with one of our fertility preservation experts. We encourage you to share your questions and concerns about fertility early in the process, so that you can make informed decisions about your particular situation.