Protecting Fertility During Breast Cancer Treatment

Many people with breast cancer get chemotherapy and radiation therapy. Both of these treatments can affect your fertility.

If you’d like to give birth, be sure to tell your doctor before you begin breast cancer treatment. It’s an important conversation to have. Ask questions about your specific treatment plan.

How Does Treatment Affect Fertility?

Chemotherapy uses medicine to kill cancer cells. These medicines also hurt some healthy cells, including those that make eggs. There’s no way to protect your ovaries completely during chemotherapy. The type of drugs used, the length of treatment, and a person's age all affect fertility. For some, the effect of chemotherapy is temporary.

Radiation therapy treats the cancer with radiation or radioactive substances. The potential for fertility problems from radiation isn’t as high as with chemotherapy. The radiation beams target only the affected area, away from reproductive organs. But the beams may pass through healthy tissues and organs and cause infertility. Sometimes the infertility is temporary.

Breast cancer treatment can lower your sex drive and can lessen the chances of fertility. Hormone changes, fatigue, nausea, and self-image can also lower your sexual desire.

Cancer Treatment During Pregnancy

You may have been expecting a baby when you were diagnosed with your breast cancer. Or you may have gotten pregnant during your treatment. It’s possible to receive treatment that’s safe for both you and your baby. But you and your doctor may need to change the type and timing of certain therapies.

For example, chemotherapy during the first trimester may harm the baby. Surgery for breast cancer is usually safe during pregnancy. The anesthesia drug to put you to sleep during the operation may pose some risk to the baby, so your surgeon will schedule the best time for surgery.

Many new mothers are able to safely breastfeed after their cancer treatments. Surgery or radiation may lower your milk production or make it harder for the baby to latch on. And some cancer drugs may pass through breast milk. Talk to your doctor if you plan to breastfeed.

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Should I Delay My Pregnancy Until My Treatment Ends?

There is no evidence that getting pregnant raises the chances that your breast cancer may come back. Some doctors may recommend waiting 6 months to 2 years after your diagnosis to try to have a baby. But the longer time may not be necessary for every woman.

If you have a hormone receptor-positive breast cancer, you may need hormone therapy for up to 10 years. In that case, your doctor may recommend staying on hormones for at least a couple of years before you try to conceive. Studies show that a history of breast cancer has no direct bearing on an unborn baby, or raise the risk of birth defects or other health problems.

Can Fertility Be Preserved After Treatment?

There are things you can do to increase your chance of having children later. These include:

Cryopreservation, the process of freezing and storing fertilized eggs (called embryos) for later use. Your embryos can be implanted in your womb after you recover from treatment or in a surrogate (a woman who carries the baby for you). Unfertilized eggs are more delicate and can be easily damaged during the freezing process, so preserving them is less effective.

Taking less toxic chemotherapy drugs. Some drugs may cause less damage to your reproductive organs, but they may also be less effective at treating your breast cancer. Your oncologist can determine if a less toxic drug may work for you.

Hormonal suppression is a method that spares the reproductive system. This approach uses hormones to temporarily shut down your body's production of eggs. This process seems to protect the cells that develop into eggs from damage during breast cancer treatment.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on July 17, 2019

Sources

SOURCES:

American Cancer Society: “Could pregnancy and breastfeeding make my breast cancer come back?” “Pregnancy After Breast Cancer,” “Treating Breast Cancer During Pregnancy.”

UpToDate: "Fertility preservation in patients undergoing gonadotoxic treatment or gonadal resection.”

Breastcancer.org: “Being Diagnosed During Pregnancy,” “Pregnancy After Treatment.”

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