Preserving Fertility for Women Undergoing Cancer Treatment

There isn’t an area of life that cancer doesn’t touch, and fertility is no exception. This reality can add a difficult and even heartbreaking dimension to an already stressful experience, but if you’re a woman with cancer, you have options.

We spoke with Jennifer Mersereau, MD, director of the Fertility Preservation Program at UNC, about how cancer may affect a woman’s ability to get pregnant and the fertility preservation options available.

How Cancer Affects Fertility

Cancer can wreak havoc on fertility in several ways.

“Certain types of cancer, such as cervical, uterine or ovarian, can damage your reproductive organs and make it harder or impossible to carry a pregnancy,” Dr. Mersereau says.

Cancer treatments also can affect a woman’s eggs.

“Certain types of chemotherapy can cause permanent damage to the eggs and cause a woman’s reproductive system to age faster,” Dr. Mersereau says. “Likewise, there are certain surgeries and radiation therapies that may affect the pituitary gland in the brain, which releases hormones that stimulate egg maturation and ovulation.”

Even if the cancer or treatment doesn’t impede fertility, doctors will often encourage women to delay attempts to get pregnant for six months to five years to ensure patients are doing well after treatment. Some breast cancer patients take hormones for years after having cancer, and these would need to be stopped to attempt conception.

If a woman is in her 30s or 40s when she undergoes treatment, the recommendation to delay conception can be hard to hear, as pregnancy becomes more difficult to achieve with age.

The Likelihood of Cancer Causing Infertility

Each situation is different, so several factors need to be considered to determine if a woman may have trouble conceiving later. Women concerned about how cancer and treatment will affect their fertility are encouraged to discuss the issue with their oncology team or a reproductive specialist.

When considering the risk to fertility, your doctor will take into account the type of cancer you have and the treatment you will need. Age is also an important indicator of how the cancer will affect fertility.

“Cancer treatments may pose less risk to a woman’s fertility if she is younger than 30,” Dr. Mersereau says. “If she is between 30 and 40, there is a moderate risk. If she is older than 40, the risk significantly increases.”

Fertility Preservation Options

If you have been diagnosed with cancer and having a child is important to you, you have several options to help preserve your fertility before beginning treatment. These include:

In vitro fertilization with embryo freezing: During IVF, you will take medications to stimulate the ovaries to produce more eggs. Those eggs then are collected and taken to a lab where they are fertilized with sperm. If successful, the egg will develop into an embryo that will then be frozen and put into your uterus later.

Egg freezing: During this modified version of the IVF procedure, eggs are removed from your ovaries to be frozen and stored. Here, the eggs aren’t fertilized with sperm. They’re simply stored in a frozen state and thawed and fertilized later. This is a good option for women without a male partner.

Each woman is different, and a doctor can help you decide which method is best based on your circumstances.

It’s important to note that fertility preservation options may be expensive. Insurance providers or employers sometimes cover the procedure.

Concerns About Pregnancy After Cancer

Many women express concerns about having children once they’ve had cancer because they’re worried about a recurrence or that being pregnant will increase their chance of recurrence because of hormone fluctuations. This is especially true for breast cancer patients. However, the literature has been reassuring that pregnancy does not seem to make recurrence more likely, even in women with breast cancer.

“Bring up the conversation of fertility preservation with your oncology team immediately after a cancer diagnosis if having children is important to you,” Dr. Mersereau says.

If that conversation occurs early in the process, there is a greater chance of having a positive fertility outcome.

In addition to your oncology team, physicians with UNC Fertility can walk through your situation with you and help decide which fertility preservation option is right for you.

Talk to your oncology team about your fertility treatment or learn more at UNC Fertility.