Breast Cancer and Fertility

Protecting Your Future Family

If you’ve been diagnosed with breast cancer, you probably have a lot of questions and concerns about cancer treatment.  If you are still premenopausal, in your fertile years, you should be aware that cancer treatment can affect your fertility and your ability to have a family in the future.

The best time to investigate your options is before you start cancer treatment, so you can preserve your fertility if your prognosis is good.  The oncologist’s first concern is to get you cancer-free, but they may be able to help you manage your fertility if your condition permits it.

How Cancer Treatment Affects Fertility

Some treatments for breast cancer can cause temporary infertility or hinder your ability to get pregnant after treatment ends, according to Breastcancer.org. Other treatments cause permanent menopause, which means you are infertile.

Hormonal therapies used in premenopausal women can make your ovaries stop producing eggs and may cause your periods to be irregular or to stop entirely.  Many women’s periods will start again after the treatment is done and are still fertile.  But some women have problems getting pregnant after hormone therapy.

Surgery to remove the ovaries and some medications will cause the ovaries to shut down and stop producing eggs.  This type of infertility is permanent.

Chemotherapy may damage some of your eggs and may cause your periods to become irregular or to stop.  Younger women may be able to regain their fertility after treatment ends.  If you are close to menopause when starting chemotherapy, you may become permanently infertile.

Options to Preserve Fertility

The first question you will want to ask is, what’s your prognosis?  How serious is your condition?  Ask your doctor if you should consider becoming pregnant after cancer treatment.  Would it increase your risk of a recurrence?

If your prognosis is good and pregnancy will not be risky for you, then you can explore options for preserving your fertility.  Egg freezing, IVF treatment to produce embryos for freezing, and in some cases freezing ovarian tissue are possible alternatives to enable you to have a baby in the future.

Your doctor will advise you on the use of medications for ovarian stimulation, which is necessary for egg freezing and for IVF, and whether it is safe for you.  Another consideration is whether it is unwise to delay cancer treatment for the six weeks or so needed for ovarian stimulation and IVF.  Do you have a male partner who is willing to participate in IVF treatment?   If you use donor sperm, are you able to be a single parent?  There are also financial implications to fertility preservation.  In most states, health insurance is not required to cover the costs of egg freezing or IVF.  Be aware that if you choose to freeze eggs or embryos, you will have to undergo IVF treatment in the future in order to use them.  A typical IVF cycle in the U.S. costs $10,000 plus the cost of fertility medications, which can run $5,000 to $10,000.   It costs about $10,000 to freeze eggs, and about $500 a year to store them.

Other Ways to Be a Parent

If fertility treatment is too risky for you, there are other ways to build a family.  Adoption is a wonderful option for those who can open their hearts and homes to a child in need.  If your own eggs are no longer viable but fertility treatment is safe for you, you can use donor eggs, your partner’s sperm or donor sperm, and IVF to become pregnant and carry a child.  Surrogacy is also an option if you are unable to carry a child.