Fertility after chemotherapy
Thursday, October 27, 2022
Many cancer treatments can affect a woman’s fertility. Most likely, your doctor will talk with you about whether or not cancer treatment may increase the risk of, or cause, infertility. However, not all doctors bring up this topic. Sometimes you may need to initiate this conversation.
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. This can cause your menstrual periods to become irregular or even stop (early menopause in premenopausal women). The older you are, the more likely your periods will not return. After chemotherapy, you may also experience hot flashes, vaginal dryness, urinary problems, and sleep problems. Chemotherapy can also lower the number of healthy eggs in the ovaries. Women who are closer to the age of natural menopause may have a greater risk of infertility.
If you want to have children after your breast cancer treatment, your oncologist may recommend that you take steps to preserve your fertility. One option may be to see a fertility specialist before your treatment.
This should be done as soon as possible after diagnosis to prevent any delays in your treatment.
Many women successfully go through treatment and then have a healthy baby. Fertility after chemotherapy depends on two things:
1- Age: Women who are treated for cancer younger than age 30 have the best chance of becoming pregnant after chemotherapy. Overall, the younger you are, the more likely it is your ovaries will produce fertile eggs after chemotherapy.
The closer you are to menopause (the average age is 51), the more likely it is that you’ll be in menopause after chemotherapy and won’t be able to become pregnant. Women who are 40 or older when they get chemotherapy are more likely to be in menopause after chemotherapy.
2- The types and doses of chemotherapy medicines: Chemotherapy medicines are usually given in combination, not each one by itself. When used in combination, the medicines’ effect on fertility may be different. It’s also important to know that the same medicine may be given in different doses in different combinations.
What happens at a fertility clinic?
It’s normal to feel a bit anxious before attending the first appointment at the fertility clinic. you’ll normally be given verbal and written information. You’ll have the opportunity to ask questions and will be offered specialist counselling. You’ll be able to discuss the options for preserving fertility, the likely success of any fertility treatments, what the procedure involves and the risks.
If you decide to go ahead with fertility preservation, you’ll need to have some tests. This will include blood tests for HIV and hepatitis.
Sometimes a blood test will be done to check the level of a hormone called AMH (anti-mullerian hormone). You may also have a transvaginal ultrasound scan, where a scan, this can check your current fertility.
These tests may happen at your first appointment. The results of these tests will help the fertility team decide whether you’ll be able to have the fertility treatment suggested.
If you’re hoping to freeze embryos, your partner will also need to have blood tests and give a sperm sample.
There are the most important questions you have you should ask a fertility consultant:
• Can I check if I’m fertile before my breast cancer treatment starts?
• Is there another type of fertility treatment that might be less risky for me?
• How will my age affect my fertility?
• What are my chances of getting pregnant after treatment?
• How safe is it for me to become pregnant?
• How long after treatment will I have to wait to find out if I’m still fertile?
• How can I try to preserve my fertility?
• Will I be able to have fertility treatment (including embryo or egg storage)? how much will it cost?
• What does fertility treatment involve?
• How successful are the different methods of preserving fertility?