Patient education: Preserving fertility after cancer treatment in women (The Basics)

What is fertility? — 

For women, fertility is the ability to get pregnant. Some types of cancer treatment can affect a person's fertility. "Preserving fertility" means taking steps to help your chances of having biological children after cancer treatment.

Even if you aren't planning on trying to get pregnant anytime soon, it's still important to think about this. That's because some types of cancer treatments can cause fertility problems in the future, even years later.

Which cancer treatments can cause fertility problems? — 

Cancer treatments that can cause fertility problems include:

●Chemotherapy – These are medicines that kill cancer cells or stop them from growing.

●Radiation therapy – This involves getting high doses of X-rays.

●Surgery – If the ovaries (female sex organs) are removed, it is not possible to get pregnant naturally (figure 1). If the uterus is removed, it is not possible to carry a pregnancy.

Chemotherapy and radiation can damage or destroy eggs in the ovaries. As a result, you might stop having periods or have irregular periods. Also, radiation can damage the uterus, which can make it hard to carry a pregnancy.

Not everyone who gets chemotherapy or radiation will have fertility problems. With chemotherapy, it depends on the medicine and the dose. With radiation, it depends on the dose and the body part treated.

What should I do if I want to get pregnant someday? — 

Tell your doctor before you start cancer treatment. It might be possible to choose treatments with a lower chance of affecting future fertility.

Are there other ways to preserve fertility? — 

Yes. Different things can be done to help preserve fertility.

If you are getting chemotherapy, your options might include:

●Embryo banking – This means collecting eggs before you start cancer treatment. A doctor fertilizes the eggs with sperm in a lab to make embryos. An embryo is a group of cells that grow after an egg and sperm join together. The embryos can then be frozen and stored for use later.

●Freezing and storing eggs or tissue from your ovaries – This gives you the option to have your eggs fertilized in the future.

●Taking medicines to keep your ovaries from working as well during your cancer treatment – This is being studied.

If you are getting radiation, your options might include:

●Shielding your ovaries or uterus during radiation treatment – This means wearing a special shield on the outside of your body during radiation treatment. The shield covers and protects your organs, so they aren't damaged by the radiation.

●Moving your ovaries – If your ovaries are in the path of the radiation, your doctor can perform surgery to move them slightly to keep them from getting damaged.

If you are going through both chemotherapy and radiation, all the above might be options for you.

Which option is right for me? — 

The best way to preserve your fertility depends on your cancer, treatment, age, and individual situation. Talk with your doctor about your different choices. To decide, you might want to think about:

●The benefits and downsides of each option

●Whether you have a partner you plan to start a family with

●How long each option would take – For example, embryo banking takes a few weeks. This could delay the start of your cancer treatment.

●How well your doctor thinks they will work

●How much they cost – For example, it costs money to collect, freeze, and store embryos. Health insurance might pay for this.

What if I still can't get pregnant? — 

If you still can't get pregnant after cancer treatment, you have other choices:

●You and your partner can try to have a baby using a donated egg.

●You can have another person (called a "gestational carrier") carry a pregnancy for you.

●You can adopt.

It can be difficult to make these decisions. You might find it helpful to talk to a counselor or go to a support group for people who are facing the same issues.

More on this topic

Patient education: Chemotherapy (The Basics)
Patient education: External beam radiation therapy (The Basics)
Patient education: Breast cancer (The Basics)
Patient education: Cervical cancer (The Basics)
Patient education: Ovarian cancer (The Basics)
Patient education: Uterine cancer (The Basics)
Patient education: Vaginal cancer (The Basics)
Patient education: Absent or irregular periods (The Basics)
Patient education: Female infertility (The Basics)
Patient education: Preserving fertility after cancer treatment in men (The Basics)
Patient education: Preserving fertility after cancer treatment in children (The Basics)

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