For many years, women who were breast cancer survivors were able to resume their life before their diagnosis - enjoying hobbies, maintaining successful careers and pursuing their life dreams. One exception, however, was being able to have children using their own eggs. But advances in technology along with increased awareness of proactive steps that can be taken to preserve fertility have changed that.
One survey suggests that half of all reproductive-aged women with invasive breast cancer desire to give birth after cancer treatment ends, and 1 in 10 will do so.
Be proactive
If you’ve been diagnosed with breast cancer, it’s important to know your options when it comes to fertility. Your fertility following breast cancer treatment depends largely on the type of cancer you have and the type of treatment you receive. If you are hoping to have children following breast cancer treatment, discuss your concerns with your cancer doctor (oncologist). He or she may be able to adjust your breast cancer treatment regimen to protect your fertility.
You also need to see a fertility specialist (reproductive endocrinologist) right away to learn about your fertility preservation options. Specialists in our fertility network are available to help you.
Click here to locate one near you and schedule a consultation.
Fertility preservation
The American Society for Reproductive Medicine (ASRM) lists the following fertility preservation options for women with breast cancer:
- Controlled ovarian stimulation combined with the freezing of mature eggs or embryos
- Freezing of immature eggs
- Freezing of ovarian tissue
- In vitro maturation before freezing mature eggs
- Use of GnRH-analogs
Sound confusing? Your fertility specialist can decode this list for you, and let you know if any of these procedures are right for you.
Fertility challenges
According to ASRM, women with breast cancer face particular challenges when it comes to fertility preservation. Many women with breast cancer have a type that is considered to be ‘hormone-sensitive’, meaning that it may grow in response to hormones such as estrogen and progesterone. Since most protocols for ovarian stimulation for egg or embryo freezing result in higher than normal estrogen levels, this can be a challenge for women with certain types of breast cancer. That being said, this risk is hypothetical – there is no data to suggest that ovarian stimulation is dangerous for women with breast cancer. Fertility specialists try to be cautious in these scenarios – many use a special protocol for ovarian stimulation that does not cause estrogen levels to be very high. Still, if ovarian stimulation is risky for a particular patient, other family building alternatives may be possible.
Alternatives to embryo freezing
If you don't qualify for embryo freezing with IVF, ask your fertility specialist about other therapies. GnRH-agonists (such as Leuprolide Acetate, or Lupron) might be helpful. Dr. Jennifer Mersereau, Medical Director at the University of North Carolina Division of Reproductive Endocrinology and Infertility, tells Attain Fertility, "Some studies on GnRH-agonists show some benefit in ovarian function in women with breast cancer, although studies have only followed patients for 1 year after chemotherapy. Unfortunately, other studies on GnRH-agonists have shown mixed results. Some show benefit, some show no difference, although none show harm." Ask your doctor if GnRH-agonists, or other therapies, might help protect your fertility during breast cancer treatment.
Pursuing parenthood
If you have breast cancer, and are interested in becoming a mother, take action to protect your fertility before cancer treatment begins. Ask a fertility specialist about your choices. Many women become parents via adoption, in vitro fertilization (IVF) with donor eggs, or gestational carrier arrangements. These family building options may be available for you if you are unable to become pregnant on your own after cancer treatment ends.
Reviewed September 2011 by Dr. Jennifer Mersereau, Medical Director at the University of North Carolina (UNC) Division of Reproductive Endocrinology and Infertility.
Sources: American Society for Reproductive Medicine http://www.asrm.org; American Society of Clinical Oncology http://www.cancer.net/; Fertile Hope http://www.fertilehope.org/
