As part of Breast Cancer Awareness Month, many questions arise around the topic of breast cancer and how it can be prevented, treated, and what types of impact it can have on your life and future plans. At PFCLA, we feel that it is important to contribute to the sharing of knowledge about how breast cancer can potentially affect your life with respect to reproduction, and what you can do to prepare for your future in the event that breast cancer becomes one of those obstacles in your life.
This article is intended to share with you how breast cancer can impact your fertility and chances of pregnancy, along with what you can do to prepare yourself before undergoing cancer treatment. We know that these treatments can be long and intense on the body; we hope that this article’s information will provide you with some reassurances and options to still allow you to have children after recovery.
It is very important to talk to your doctor to evaluate how breast cancer treatment may affect your fertility before starting cancer treatment. Young women with breast cancer may want to have a child after completing treatment. However, some treatments for breast cancer, such as certain types of chemotherapy, could cause or contribute to infertility.
Infertility can be caused by various reasons such as low ovarian reserve, poor egg quality due to age, unbalanced hormone levels, and damage to the reproductive system that prevents eggs from being released and/or fertilized. Females are born with only a certain number of eggs; certain hormones allow mature eggs to be released every month during the menstrual cycle until the female reaches menopause.
Chemotherapy can cause infertility in women who are pre-menopausal. It can cause your menstrual cycles to stop temporarily or permanently. It can also affect ovarian functions by reducing the number and quality of eggs. However, there are different methods of preserving a woman’s fertility before starting breast cancer treatment.
Several options may be available to you before you start your breast cancer treatment. In-vitro fertilization (IVF) is the most effective way of preserving fertility.
IVF is the process of the extraction of eggs from the ovaries, fertilization in the laboratory with sperm, and subsequently, transfer of the embryo(s) into the uterus.
If you do not have a male partner and do not want to use donor sperm, you may want to freeze your eggs for later use. For an egg-freezing cycle, fertility hormonal medications are usually started on the second day or third day of a woman's menstrual cycle. We use different types of hormonal medications to stimulate the ovaries to produce multiple eggs. The response to these medications varies according to the patient’s age, ovarian reserve, and the amount of medication dosage given. These medications are usually given once daily. It usually takes an average of 10 to 14 days from the medication's start date to the actual egg retrieval procedure. The mature eggs will be retrieved, frozen, and stored at our IVF lab. You can choose to thaw the frozen eggs later to fertilize them into embryos, and then prepare for an embryo transfer procedure to achieve pregnancy.
Though a slow-freeze method for egg freezing exists, PFCLA only offers egg vitrification. The reason for this is simple: the faster alternative has been shown to produce higher pregnancy rates. After vitrification, the eggs remain frozen until you’re ready to become pregnant, at which time the eggs are removed from the liquid nitrogen and thawed before being fertilized and placed in your uterus.
Embryo freezing is the most effective and recommended way of preserving fertility. You can choose to freeze embryos using your partner’s sperm or a donor’s sperm. Once the eggs are retrieved and cleaned in the laboratory, they are either incubated with sperm overnight or sperm is directly injected into each egg to fertilize it.
The next day after insemination, the embryologist will check on the status of the fertilized eggs. A fertilized egg is called an embryo. An embryo goes through stages of development with culturing. Embryos will be cryopreserved for the intent to use at a later time.
Talking to your doctor about possible IVF treatment will give you a better opportunity of having children after the breast cancer treatment. Fertility treatment can delay chemotherapy for a short period of time. Ovarian suppression via OCPs can be used to try to protect the ovaries during chemotherapy. Please discuss any concerns you have with your fertility specialist. At PFCLA, our fertility specialists will evaluate each case and provide options for the best treatment plan for each patient.
In general, pregnancy after cancer treatment is considered safe for both the mother and the baby. Many women can become pregnant after being treated for breast cancer. Breast cancer survivors who want to become pregnant are sometimes advised to wait for a certain period of time after finishing chemotherapy before getting pregnant. This is because if the cancer were to come back in the earlier years, cancer treatment during pregnancy can be more complicated for both you and your child. If you have had breast cancer and are thinking about having children, please talk with your doctor. Ask how cancer and its treatment might affect your chances of pregnancy. It is still very hopeful for younger breast cancer survivors to achieve a successful pregnancy and healthy childbirth.
It is helpful for breast cancer survivors to share their thoughts and journeys with women who are at the same stage of life and may have similar concerns about fertility and having children. Your battle with breast cancer is a hard and difficult one, but it’s important to remember that you are not alone in this fight. Having a strong support system around you when times are tough can be a journey-changing experience. Never give up.
Below are some links that can be helpful:
Preserve your fertility, no matter your circumstances, with our egg and embryo freezing services. Thanks to egg and embryo freezing, many women can take time to focus on the hurdles in front of them without worrying about their fertility.
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Note: This is not intended to be a substitute for professional medical advice, diagnosis or treatment. Information provided is for general educational purposes only and is subject to change without notice. Speak to your doctor directly with any questions you may have regarding a medical condition. Any information contained herein does not replace any care plan as determined by a physician.
¹Birth rate percentage using aggregate data from ALL age groups on the Live Births Per Intended Egg Retrieval (ALL EMBRYO TRANSFERS) of Patient's Own Eggs chart for 2020. Reference: PFCLA SART | NATIONAL SART
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