Breast Cancer and Preserving Fertility

Some treatments for breast cancer, such as chemotherapy and radiation therapy can affect your ability to become pregnant. 

 Having breast cancer treatment may mean you have to think about your fertility sooner than you planned. While your main concern is probably treating your breast cancer, if having children of your own is important to you, it’s important to talk to your doctor about the procedures to preserve your fertility before your breast cancer treatment begins.

In premenopausal women (those who have not yet reached natural menopause), some types of treatment can trigger early menopause symptoms, sexual problems, and fertility problems. Some of these treatments can also increase the risk of certain long-term health problems. 

 Natural menopause occurs when the ovaries stop making estrogen. Normally, this happens over a period of several years. But certain forms of breast cancer therapy, like chemotherapy, can affect the function of the ovaries, reducing the number and quality of eggs. This can trigger symptoms of early menopause in premenopausal women.

The likelihood of you having fertility problems in the future depends on the type of drugs used, the dose given, your age, and what your fertility was like before breast cancer treatment.

Fertility preservation procedures

 Some younger women do not want children or choose to start their cancer treatment and wait to see if fertility returns when treatment is over. 

Very young women who are more likely to maintain their fertility after breast cancer treatment may want to discuss this option with their treatment team. Your fertility specialist can do some blood tests and an ultrasound scan to assess your fertility before your breast cancer treatment begins. They can also monitor your fertility after treatment.

Here are the preservation procedures:

1- Stimulating the ovaries to produce more eggs

Fertility preservation can stimulate your ovaries to produce eggs and help them mature. This is known as ovarian stimulation. Collecting more eggs will increase the chances of pregnancy in the future.

You’ll need daily injections of hormones to help your ovaries produce more eggs than usual. This will stop natural ovulation so that the eggs can be collected in the timeframe required by the fertility specialist. This procedure can delay chemotherapy for a short time. You can discuss any concerns you have with your fertility specialist.

2- Egg freezing 

Eggs are collected after ovarian stimulation. These eggs are then frozen. Frozen eggs can be stored for 10 years or longer. They can then be thawed and fertilized with sperm from a partner before being implanted in the womb when you want to try to get pregnant. For the best chance of success at a live birth in the future, it is best to freeze your eggs before you are 34. The patient will be given hormonal medication that stimulates the ovaries to produce mature eggs, which are then harvested during a short invasive surgical procedure. These will then be frozen through a fast-freezing process that ensures the cells remain structurally intact and are not damaged. When ready for pregnancy, your eggs are thawed and fertilized using IVF- ICSI.

3- Embryo freezing

 Embryo freezing is the most effective way of preserving fertility. You must undergo a procedure called in vitro fertilization (IVF). In IVF, you will be given hormones to stimulate the ovaries to produce a number of eggs. Once they are developed, the eggs will be removed by gentle suction. Embryos are created in the laboratory by joining together the sperm and the egg. The fertilized eggs or embryos are then frozen.

4- Pre-implantation genetic diagnosis (PGD)

 Women who are known to have inherited an altered breast cancer gene that increases the risk of breast cancer and are concerned about passing this on to future children may want to talk to their genetic counselor about the possibility of pre-implantation genetic diagnosis. 

 This involves going through an IVF cycle and checking the embryos for the inherited altered gene before freezing them. Only the embryos that are not affected by the altered breast cancer gene are used.

For more information on fertility preservation call 800-FAKIH(32544) or visit https://fakihivf.com/book-an-appointment/