Memorial Sloan-Kettering Cancer Center fertility specialist Joanne Frankel Kelvin discusses the impact that cancer treatment can have on a woman’s fertility, and how patients can plan a family after treatment.
Many types of chemotherapy and hormonal therapies can cause reproductive problems. About one-third of all women under the age of 40 who have chemotherapy go into permanent menopause. Of those over 40, two-thirds between the ages of 40 and 45 and 90 percent of those 46 and over begin menopause. Some women experience temporary or permanent infertility or menstrual irregularities.
Methods to preserve fertility include the following:
- Embryo preservation, a process in which eggs are removed and fertilized. The embryos are stored for implantation after cancer treatment is completed and the patient is deemed ready for pregnancy.
- Experimental approaches, such as freezing of unfertilized eggs, freezing ovarian tissue and later transplanting it back into the woman's body, and suppressing ovarian function with medications. This final approach can create a temporary resting state and possibly reduce the damage to the ovaries from chemotherapy.
The decision to undergo any of these treatments should only be made after a discussion with a medical oncologist. Unfortunately, there is very little available information on the safety or effectiveness of these interventions for women with breast cancer. In general, however, women are advised not to become pregnant for several years after breast cancer treatment because of uncertainties regarding the impact of high hormone levels as well as concerns that a pregnancy might be complicated by a cancer recurrence. Some of these same concerns could apply to the hormone levels needed to create the right uterine environment for embryo implantation. An additional concern is the delay in systemic treatment for breast cancer required to pursue embryo preservation.
If you are concerned about your reproductive health or risk of infertility after breast cancer treatment, be sure to address this issue with your doctor while you are planning your therapy.
Memorial Sloan-Kettering has established a program to address fertility preservation and parenthood after cancer treatment. Speak to your doctor or nurse and ask for a referral to the Clinical Nurse Specialist of the Fertility Preservation and Parenthood After Cancer Treatment program. Learn more.