Breast cancer touches millions of people around the globe, presenting physical and emotional hurdles and also raising concerns about fertility. According to the World Health Organization, breast cancer is the most common cancer among women globally, with approximately 2.3 million new cases diagnosed each year.
Although breast cancer is a challenging diagnosis for anyone, it can be particularly daunting for young women who would like biological children but haven’t yet started or completed their families. It’s essential to understand the impact of breast cancer on fertility and to explore preservation options, like egg or embryo freezing.
If you’ve been diagnosed with breast cancer, ask your oncology team as soon as possible for information about your recommended treatment plan, how it can impact your fertility, and your available options.
Read on to learn how breast cancer treatment intersects with fertility and the options available for those hoping to have children.
The Impact of Breast Cancer Treatment on Fertility
Breast cancer treatments, including chemotherapy, radiation, and hormonal therapy, can significantly impact a woman’s ability to conceive. Some cancer treatments can lead to temporary or permanent infertility in premenopausal women. These treatments can affect fertility in several ways:
Chemotherapy: Many chemotherapy drugs have the potential to harm the ovaries, which can significantly decrease the number of viable eggs essential for fertility. As a result, women undergoing chemotherapy may be less likely to conceive.
In some cases, this ovarian damage can be severe enough to lead to premature ovarian failure, a condition where the ovaries stop functioning correctly before the age of 40. This can lead to early menopause in some cases, with associated symptoms such as hot flashes, night sweats, and infertility. The impact of chemotherapy on ovarian health underscores the importance of discussing fertility preservation options with healthcare providers before starting treatment.
Radiation Therapy: For individuals whose breast cancer has metastasized to areas requiring radiation near the pelvic region, there are significant considerations regarding fertility.
Radiation therapy targeting the pelvic area can damage reproductive organs, which may adversely impact fertility. In females, exposure to radiation near the ovaries can reduce the number of viable eggs, cause hormonal imbalances, or even trigger premature menopause. In males, radiation near the testes can affect sperm production and quality, potentially leading to reduced fertility or infertility.
The degree of reproductive damage depends on factors such as radiation dose, the specific areas treated, and the individual’s overall health and age. It is crucial for those undergoing radiation therapy to discuss potential reproductive risks with their healthcare providers beforehand. Options like egg or sperm banking may be available to help preserve fertility.
BRCA Gene Mutations and Prophylactic Surgery: People with a BRCA 1 or BRCA 2 gene mutation face a high risk of ovarian and breast cancer. Many opt for prophylactic surgery to remove the ovaries and fallopian tubes (salpingo-oophorectomy) to significantly reduce this risk. This preventive measure is crucial in lowering the chances of developing ovarian cancer, which is often hard to detect early.
Hormonal Therapy: Treatments like tamoxifen, which are used to block estrogen receptors, can have significant effects on a woman’s reproductive system. These medications can disrupt menstrual cycles, causing irregular periods or even complete cessation of menstruation. This disruption can impact fertility, making it more difficult for women to conceive while undergoing treatment.
Additionally, the effects on the menstrual cycle can vary from person to person, and some women may experience other related side effects, such as hot flashes or changes in mood. It is important for women who are considering or undergoing such treatments to discuss the potential impact on their fertility and menstrual health with their healthcare provider.
Fertility Preservation Options
For women diagnosed with breast cancer who wish to preserve their fertility, there are several options available. It is important to discuss all available options as soon as possible with your oncology team before starting active cancer treatment.
Egg and Embryo Freezing
The most established methods for preserving fertility are embryo and egg freezing, also known as oocyte cryopreservation. These procedures involve stimulating the ovaries to produce multiple eggs, which are harvested and frozen for future use.
Ovarian Tissue Freezing
For women who need to start cancer treatment urgently, ovarian tissue freezing may be an option. The procedure involves surgically removing and freezing ovarian tissue, which can later be re-implanted.
Ovarian Suppression
Some doctors may recommend medications to suppress ovarian function during chemotherapy, potentially protecting the ovaries from damage.
In Vitro Maturation (IVM)
Another option, IVM, involves retrieving immature eggs and maturing them in a lab setting before freezing.
Making Decisions About Fertility Preservation
Deciding whether to pursue fertility preservation is a personal choice that depends on various factors:
Your age and current fertility status
Your treatment plan
Your desire for future biological children
Financial considerations, including potential insurance coverage
Discussing these options with your oncologist and a fertility specialist as soon as possible after diagnosis is crucial.
The Emotional and Psychological Impact
A breast cancer diagnosis is overwhelming, and the added stress of potential infertility can exacerbate the emotional and psychological challenges. Women may experience:
Anxiety and Depression: Concerns about fertility and the future can lead to significant mental health issues.
Relationship Strain: Fertility concerns can place additional stress on relationships.
Decision-Making Stress: Choosing a fertility preservation method can be daunting, especially when facing a cancer diagnosis and needing to make decisions quickly.
Seeking Support
Counseling: Professional counseling can help address the emotional and psychological impacts of breast cancer and fertility concerns.
Support Groups: Joining support groups for people with breast cancer can provide a sense of community and shared experiences. Check out one of the many Surviving Breast Cancer support groups.
More Options Through Surrogacy or Adoption
When faced with fertility challenges, both surrogacy and adoption offer hopeful pathways to building or growing a family. Surrogacy allows prospective parents to have a child genetically related to them through the assistance of a surrogate who carries the pregnancy.
On the other hand, adoption provides the opportunity to welcome a child into a loving home, offering them a stable and supportive environment. Both options come with emotional, legal, and logistical considerations, but they provide fulfilling routes to parenthood for individuals and couples who are unable to become pregnant.
Count On Us for Information, Resources, and Support
A breast cancer diagnosis doesn’t necessarily mean the end of your dreams for a family. With early discussions and proper planning, many women can preserve their fertility and have biological children after cancer treatment. Always consult your healthcare team to understand the best options for your situation.
Whether you’re newly diagnosed with breast cancer, are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms, testing, treatment options, surgery, etc., and podcasts that feature professionals, advocates, and caregivers who share valuable information.
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Note: This article is designed to provide general information and is not meant to replace professional medical advice. Always discuss your options with your healthcare provider.
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