Preserving a woman’s fertility after a cancer diagnosis

A cancer diagnosis comes like a damn cold shower you can’t warm up from. Fear overwhelms you and leaves you breathless, but at the same time a spring is triggered internally that pushes you to climb the slope and fight for yourself and for those who live around you.

However, often during initial doctor visits,   diagnostic tests, and treatment planning,  everything related to fertility preservation and options for evaluating the possibility of becoming a mother after cancer can be overlooked.

All women of childbearing age who find themselves having to fight against cancer should be informed in advance about the various options and the consequences that, for example, a treatment of chemotherapy can entail.

Many of the chemotherapies that are used to treat breast cancer can affect fertility. The closer a woman is to her natural age of menopause, the more likely she is to experience menopause after treatment. For example, at age 40, a woman has a 50-60% chance of going through permanent menopause after treatment with most of the chemotherapies that are routinely used to treat breast cancer.

A woman of childbearing age should always be informed about the existence of some valid options to become mothers after the therapies:

1) Freezing of oocytes and/or embryos. The most effective way to preserve fertility is to freeze eggs or embryos for future use. It’s a very personal choice that can be influenced by the type of relationship you live, by your personal or religious beliefs. The procedure requires stimulation with some drugs to make the ovaries produce many follicles which are then removed through a small outpatient procedure. The oocytes can simply be frozen, or they can be fertilized in vitro to obtain embryos which are in turn frozen. This process can take from 2 to 6 weeks.

2) Freezing of the ovarian tissue : it is an experimental technique with which, through an outpatient procedure, parts of the ovaries are removed and frozen for possible subsequent use. If the woman goes through menopause after chemotherapy, the ovarian tissue can be thawed and later reimplanted into the ovaries.

This technique can be considered in the case of a young woman who does not have enough time to face the stimulation process before tackling the therapies.

It is not a recommended option if the woman carries the BRCA gene mutation that predisposes her to a high risk of ovarian cancer, or if she suffers from leukemia.

3) Ovarian suppression . The woman is given a drug that temporarily puts her ovarian activity to rest . This makes the ovaries more resistant to the damage of chemotherapy.

4) Heterologous fertilization. Once recovered, the woman could opt for a pregnancy thanks to oocytes from a donor.

5) Adoption . Adoption is always a valid alternative to becoming a parent.

Whatever your choice, if you think you want a child or more children in the future, do not neglect to discuss this aspect with your oncologist before starting drug treatments for cancer.