A breast cancer diagnosis can lead to many things…emotional pain, physical discomfort, and, for women of childbearing age, the fear of losing their fertility. Thankfully, advances in cancer treatment are enabling more women than ever to survive and thrive in the face of their diagnosis. Advancements in reproductive technology, specifically, provide effective fertility preservation options to breast cancer patients – giving them the opportunity to make children a part of their bright future.
With National Breast Cancer Month upon us, Cary L. Dicken, MD of Sher Fertility Institute New York in Manhattan describes how some therapies that improve the odds of surviving cancer have side effects that include loss of fertility and menopause, and how the right treatment plan can help circumvent these baby-making obstacles.
Infertility Risks for Breast Cancer Patients
There are many factors involved in determining the risk of infertility after cancer treatment, such as age, treatment type, and underlying fertility potential. If the cancer is treatable by surgery alone, there is no risk of infertility (related to the cancer diagnosis). The jury is still out on radiation; it may have some affect on fertility. However, there’s a clear correlation between chemotherapy and potential loss of fertility.
Chemotherapy can impact egg quality, affect ovarian reserve and even bring on premature ovarian failure, or early menopause. Ovarian failure is similar to menopause in that the ovaries stop producing eggs and menstruation comes to a halt. Some women find that their ovaries regain function after a period of time has passed. However, older women or those who have had higher doses of chemotherapy may never regain ovarian function.
Pre-Cancer Fertility Preservation Options
If you’re a breast cancer patient who hopes to have children someday, educating yourself on fertility preservation options is one of the best steps you can take to maintain control of your future. Your doctor at Sher Fertility Institute New York will work closely with you to determine which choice is right for you.
- IVF (In Vitro Fertilization) & Embryo Banking: Embryo banking is the most established form of fertility preservation and is a wonderful option for women with a male partner or those interested in using donor sperm. IVF and embryo banking involves stimulating the ovaries to produce multiple eggs, combining the eggs with sperm in a laboratory setting, and freezing the resulting embryos. The process occurs over two to four weeks, so is best for women who can safely delay cancer therapy for that amount of time. The embryos are implanted after cancer treatment and recovery.
- Egg Banking: The process to bank eggs is similar to embryo banking in that it involves the same ovarian stimulation to produce multiple eggs. The eggs are retrieved from the ovaries and then frozen without being fertilized; they are fertilized at a later date and the resulting embryos are implanted after cancer treatment and recovery.
- Ovarian Tissue Banking: This is an option for women who cannot safely delay cancer treatment long enough to undergo embryo or egg banking. Laparoscopy, a minor surgical procedure, is used to remove one ovary. The cortex, or outer surface, contains the eggs; it is removed and frozen in strips for later use. Women who have had certain types of cancer can then have the tissue thawed and transplanted back.
Post-Cancer Fertility Preservation Options
If possible, it’s best to consult with a reproductive endocrinologist prior to undergoing cancer therapy. However, for some women that’s not possible. The good news is that there are options to grow your family after you’ve completed treatment for cancer. It does not appear that pregnancy after cancer increases the risks of cancer recurrence, nor do children born to cancer survivors appear to be at higher risk of birth defects. Researchers continue to gather more data, but the information available to date is reassuring.
After cancer treatment, traditional assisted reproductive technologies including controlled ovarian hyperstimulation, IUE (Intrauterine Insemination), and IVF may be a viable way for some cancer patients to become pregnant.
Egg donation is an excellent choice for women whose cancer therapy caused them to become menopausal. A known or anonymous egg donor would undergo ovarian stimulation. Her eggs would be fertilized by sperm, and the resulting embryos would be implanted in the cancer survivor.
Some cancer survivors who are unable to carry a pregnancy turn to gestational surrogacy. The patient would undergo IVF, and the embryos from the intended parents (the patient and her partner) would be implanted into the gestational surrogate.
More than ever, patients who undergo fertility-threatening cancer treatments are surviving their disease and looking forward to the future. Building a family is often a very important part of that future. If you’re a cancer patient and would like more information on the fertility preserving options available to you, call (646) 792-7476 to schedule an appointment today. At Sher Fertility Institute New York we recognize that time is often of the essence and are committed to making every effort to see you as soon as possible.