Oncofertility: Breast Cancer

Breast Cancer & Fertility

Infertility is commonly defined by our esteemed Fertility Specialists as the inability of a couple to conceive naturally after having tried for at least a year.

Most people in this world will think about having children at some point in their lives.  And although, not everybody wants to have have children immediately or perhaps ever, 99.9% want to know that they at least have an option.

There are many reasons for infertility which we have discussed in detail in our blog “7 Signs of Infertility” however, a major cause of infertility that is sometimes not expected and extremely traumatic, is cancer.  As October is Breast Cancer Awareness month, we have decided to focus on this particular cancer and how you can preserve your fertility if you are every diagnosed with breast cancer, or any cancer for that matter.

What If my cancer has been caught early?

If your cancer is caught in the early stages, some treatments can cause temporary infertility or they can make it very difficult for you to get pregnant, post-treatment. Other treatments, however, cause permanent and irreversible menopause, which means you will be permanently infertile.

What if I need Chemotherapy?

Chemotherapy may damage some of the eggs in your ovaries and may cause your periods to become irregular or stop. If you are premenopausal before starting chemotherapy, your periods may come back after treatment ends. Even if your periods don’t come back, you may still be fertile. If you’re close to menopause when you start chemotherapy, your periods may never come back and you will be permanently infertile.

If I am diagnosed with breast cancer, what are my options regarding fertility?

Most Onco-Specialists will always consider treating breast cancer more important than fertility concerns, BUT, you may not have to choose one over the other. There have been many women who have successfully gone through treatment and then have gone on to have a healthy baby.

Because every cancer is different, every treatment is different and every human being reacts differently to cancer and or treatment, It is extremely important that you immediately speak to our Fertility Specialists as soon as you have been diagnosed to fully understand your fertility options. Ask the following questions at your first appointment:

• What is my prognosis? Is it good or not so good?
• How serious is my condition? I
• Is there a chance I can become a parent in the future?
• Or the prognosis mean I cannot take any risks?
• How safe is it for me to become pregnant?
• Can my cancer affect my pregnancy in the future?

If I can fall pregnant in the future, what happens next?

If your prognosis is good and pregnancy would be relatively safe, talk to fertility specialist about preserving your fertility. Please note, you will need preserve your fertility before you start treatment.

Questions you could ask here would be:

• Is it better to freeze embryos (fertilised eggs) or only my eggs?   
  Just a note here, if you are in a committed relationship with a man – would he want you to be involved in the cryopreservation process?  If the answer is yes, we would strongly suggest you read the article written by our Fertility Lawyer, Andrew Martin regarding Embryo/Egg/Sperm Disposition
• Is ovarian stimulation (with in vitro fertilization) the only realistic option for getting enough eggs?
• Is there another type of fertility treatment that might be less risky for me?
• Should some of your ovarian tissue be frozen instead of, or in addition to, my eggs?
• Should I consider taking medication to suppress my ovaries during chemotherapy?
• What are costs involved?
• Can I  postpone treatment? Would it be safe for you to postpone treatment for 6 weeks to allow time for ovulation stimulation and in vitro fertilization?
• Are the hormones that will be used to stimulate ovulation safe for you or are the estrogen levels risky?
• Can I actually afford these fertility procedures and is anything covered by Medical Aid? You will need to find out if your health insurance whether they cover fertility procedures as many are not completely covered.

What if I am told I cannot ever fall pregnant due to my cancer?

If your ovaries permanently stop producing eggs after treatment, you can still be a parent if you are open to the idea of having a child without using your eggs. There are several options:

• Egg donation: Donated eggs come from women who volunteer to go through a cycle of hormone stimulation and have their eggs collected. After the eggs are retrieved from the donor and fertilized with your partner’s (or donated) sperm, the embryo is transferred to your uterus
• Embryo donation: A fertilized egg from another couple is transferred to your uterus
• Surrogacy: A woman becomes pregnant through artificial insemination with your partner’s sperm and carries the baby through birth
• Adoption: Adoption is available to just about anyone who would like to become a parent. While some agencies prefer a two-parent household, many others are happy to place a child in a loving-single parent home. It’s helpful to talk to an experienced adoption counselor who can help guide you through the process

We are on standby to answer any questions or concerns you have regarding fertility & preserving your fertility in the future, so do get in touch.

Love & Light,
The EDSA Team