5 Questions About Fertility and Metastatic Breast Cancer

Monday, September 9, 2019

Metastatic breast cancer (also called stage IV) is breast cancer that has spread to another part of the body, most commonly the liver, brain, bones, or lungs. you are young and premenopausal, or still having menstrual periods, breast cancer treatments can affect your fertility and make it harder for you to become pregnant. Chemotherapy can damage your ovaries, and hormonal therapy may also cause your periods to become irregular or stop.

Most doctors advise women to avoid getting pregnant while undergoing breast cancer treatment and wait for a period of time after treatment ends before trying to get pregnant.

But metastatic breast cancer, you face a number of challenges that may affect your ability and plans to have children. Are there ways you can protect your fertility and become pregnant in the future?

Here are some questions you should ask your doctor:  

1- How can MBC affect my fertility?  

Metastatic breast cancer (MBC) can cause a woman to lose her ability to have children with her own eggs. This diagnosis can also delay the timing of when a woman can become pregnant.   One reason is that after starting treatment, doctors usually ask women to wait years before pregnancy because of the risk of recurrence. The other reason is that treatment for MBC can cause early menopause. These two issues lead to a decrease in fertility rates in women who have MBC. Women are born with all the eggs we’ll ever have, but as time passes, we run out of viable eggs. Unfortunately, age is the enemy of fertility. On top of that, MBC treatment can also affect your egg counts.

2- What effect do MBC treatments have on my ability to get pregnant?  

Treatments for MBC can lead to early menopause. Depending on your age at diagnosis, this could mean a lower likelihood of a future pregnancy.

3- Can I Temporarily Stop Treatment to become pregnant?   

This is a question that depends on the treatments you’ll need and your specific case of MBC. It’s important to thoroughly talk this through with your doctors to weigh your options before making a decision.

Some situations prevent treatment breaks, such as fast-growing disease or cancer that causes pain or physical symptoms. But if cancer has been stable for a time, your doctor may be open to interrupting treatment or, in some cases, delaying the start of treatment so that you can get pregnant and have children. You may also be able to get pregnant and have children while continuing with certain treatments.

4- Can I Protect My Fertility While Living with Metastatic Breast Cancer?   

It’s important that you ask your fertility doctor about fertility-saving options as soon as possible after your diagnosis.

Assisted reproductive technology may help you become pregnant in the future. Harvesting and freezing eggs and embryos for future use is often coordinated with breast cancer treatment and performed before chemotherapy begins.

You can also shut off your ovaries with a medicine called gonadotropin-releasing hormone agonists (GnRH agonists) or luteinizing hormone-releasing agonists (LHRH agonists). These medicines may stop cancer from growing and protect your ovaries from the harsh effects of chemotherapy.

5- Will I be Able to Have Children in the Future if I am Young and Have Metastatic Disease?  

Women who didn’t preserve their fertility before cancer treatment can still get pregnant. The risk of infertility has to do with your age at the time of your diagnosis and the type of treatment you receive.   However, because long-term, permanent treatment may take a higher toll on your fertility, you may have a higher likelihood of becoming infertile than a young woman with early-stage disease.  Even if you enter premature menopause, you can have frozen eggs or embryos implanted and carry a pregnancy.