How Cancer Affects Your Ability to Have a Baby

Cancer affects thousands of women of reproductive age each year. While cancer treatments save many lives, cancer treatments leave many women infertile. Several factors influence whether your cancer treatment will affect your fertility. These factors include:

  • The type of cancer you have
  • The type and dose of cancer treatment you receive
  • Your age 

A cancer diagnosis can be stressful and devastating for all individuals, men and women alike. Men and women are both at risk for fertility problems following cancer treatment, but women have particular challenges that men do not share.

Differences between men and women

Men are often able to freeze one or more sperm samples before undergoing cancer treatment. This freezing and storing of sperm is relatively quick, easy, and inexpensive. Unfortunately, women do not have it so easy! While many men with cancer regain their ability to produce sperm within months after cancer treatment, women are not so fortunate. If a woman's eggs are damaged by cancer treatment, she will most likely need fertility treatments to try to conceive once treatment ends.

Protecting female fertility

The best way to protect your fertility during cancer treatment is to undergo embryo cryopreservation (embryo freezing and storage) before your treatment begins. Dr. Jennifer Mersereau, Medical Director at the University of North Carolina Division of Reproductive Endocrinology and Infertility, explains: "An 'urgent' in vitro fertilization (IVF) cycle with embryo cryopreservation makes sense for women with a male partner, or single women who would like to proceed using donor sperm. This is a common, standard, and successful treatment for infertile couples". If you want to learn more about the embryo freezing process, make an appointment with a fertility specialist. Know that the embryo freezing process takes several weeks to complete, and some women are not eligible for this procedure.

Embryo freezing

Embryo freezing is commonly performed as part of the in vitro fertilization (IVF) process. Here is how embryo freezing works:

  1. Your doctor stimulates your ovaries to produce multiple eggs.
  2. Mature eggs are retrieved from your ovaries during a brief outpatient procedure.
  3. Your eggs are fertilized in a lab with your partner's (or a donor's) sperm, and the embryos are frozen.

Ask a fertility specialist about fertility and cancer

After cancer treatment ends and you get the OK from your oncologist to attempt pregnancy, the embryos can be thawed and transferred into your uterus to help you conceive. This procedure may sound intense, and a bit overwhelming, but it is quite common for women to become pregnant using frozen embryos and IVF. In 2009, there were over 10,000 frozen embryo transfers with IVF. IVF success rates from these transfers were at a 35 percent chance of success for women under 35. Dr. Mersereau shares, "Younger women often see higher pregnancy rates with IVF and embryo freezing than older women." Ask your doctor if embryo freezing is right for you.

Challenges

Many women will not be able to freeze an embryo or achieve pregnancy following cancer treatment. Here are some common obstacles that women face:

  1. IVF and embryo cryopreservation are expensive and insurance does not always cover the procedures. Financial hurdles prevent many women from achieving pregnancy after cancer treatment.
  2. There may not be enough time. Cancer treatment must begin immediately after diagnosis for some women. Fertility will be a secondary priority in these cases.
  3. Single women and lesbians may not have immediate access to a sperm sample (required for embryo freezing). In these cases, a fertility clinic can help in choosing a sperm donor.  Alternately, at some fertility centers, women could undergo ovarian stimulation and freeze eggs. 
  4. Special considerations need to be made for young girls with cancer. Minors may be too young to think about future pregnancy and fertility concerns. Parents, oncologists, and fertility specialists must work together to make the best ethical decision for these young females.

If you are not able to freeze an embryo before treatment, for any reason, ask your doctor about other fertility preservation options. Some alternatives may include clinical trials, drug protocols or experimental egg and ovarian tissue freezing.

Protect your reproductive health

To achieve pregnancy and give birth after cancer treatment, your reproductive system must be healthy and functional. Radiation and chemotherapy cancer treatments may damage your ovaries and fallopian tubes. If this happens, you might not be able to get pregnant on your own, but you may be able to get pregnant with previously frozen embryos. Donor embryos may help you if you were not able to freeze embryos before your cancer treatment begins. Talk to a fertility specialist to learn more about your options for pregnancy following cancer treatment.

Medically reviewed September 2011 by Dr. Jennifer Mersereau, Medical Director at the University of North Carolina (UNC) Division of Reproductive Endocrinology and Infertility.

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