Being diagnosed with breast cancer is a stressful event, which can raise a lot of questions, especially about your current and/or future plans. If you’ve just been diagnosed with breast cancer and are considering starting or expanding your family, it’s normal to worry about the potential impact of the disease and its treatments on your ability to have children.
What is the impact of breast cancer on fertility?
It’s important to know that breast cancer itself doesn’t affect the ability to conceive a child or carry a pregnancy to term; however, some breast cancer treatments can have an impact on female and male fertility.
For example, hormone therapy may be prescribed to slow the progression of breast cancer and prevent recurrence. It can cause irregular periods or even stop them all together, resulting in a loss of fertility during, and for a short time after, treatment.
Chemotherapy drugs can damage the female reproductive system, reduce the quantity or quality of eggs, affect the functioning of the testicles and damage sperm. This can lead to decreased fertility and sometimes even infertility.
Are the effects of treatments on fertility irreversible?
Fertility problems are common during chemotherapy, but menstruation and sperm production usually resume within a few months to a few years after treatments end. This said, chemotherapy can, in some cases, irreversibly affect fertility due to its toxicity to the ovaries and testes.
The impact of this type of treatment on fertility varies from one person to another and depends on several factors, such as gender, age, type of chemotherapy, dose received and other personal characteristics and factors. Every person is different, and the impact that treatments will have on a their fertility is not always predictable.
Is it possible to preserve fertility before treatments begin?
It’s important to know that there are options for preserving your fertility after a breast cancer diagnosis; however, this must be planned, and the necessary measures must be taken before treatments begin. It’s therefore important to talk to your healthcare team as soon as possible so they can take this into account when arranging your treatments and guide you through the process. Depending on your plans, it’s important to discuss the possible impact of your treatments on your fertility, as well as your options for preserving it, in order to keep your options open.
Oncofertility specialists will work with your healthcare team to take into account your desire to start or expand your family. The options that may be suggested and explained to you will also depend on a number of factors (including your gender, age, current fertility status, and the treatments you will receive).
Methods for preserving female fertility include storing eggs, embryos or ovarian tissue and sometimes using medication to protect the ovaries. To preserve male reproductive function, sperm can be collected and stored in a sperm bank prior to certain types of chemotherapy.
Fertility during treatment
Despite the disruption of reproductive functions caused by treatments, pregnancy is still sometimes possible. This said, it remains contraindicated during treatments. Some breast cancer treatments can pose risks to the fetus. It’s therefore advisable to maintain an effective non-hormonal method of contraception, even in the absence of cycles, for women undergoing treatment as well as for female partners of men undergoing treatment. Your healthcare team is there to advise you on the different methods of contraception available and appropriate for your needs, so always feel free to ask questions.
Conceiving a child after treatment
After you’ve stopped active treatments, you may (re)start thinking about having a baby. Again, your healthcare team is there to inform you and tell you how long you should wait before considering having a child. The decision may depend on the prognosis, the risk of recurrence, your age, and the treatments received.
Taking a course of hormones for several years after treatment is a common add-on therapy for premenopausal women. If this is the case for you, and you want to consider pregnancy before the end of this treatment, your healthcare team will assess the impact of this interruption on the risk of recurrence.
If you and your oncofertility team decide that you’re ready to consider pregnancy, tests can be done to determine your chances of conceiving a child naturally. It’s important to remember that the chances of having a child naturally after treatment vary from one person to another. In the event that a natural pregnancy is not possible or unlikely, fertility professionals will explain your options for assisted reproduction.
What resources are available?
Unfortunately, sometimes pregnancy is not possible or very difficult, despite fertility preservation and assisted reproduction methods. Finding out that you’re infertile, or waiting to find out, can be difficult to accept and overcome. Know that you’re not alone. Don’t hesitate to ask for help and talk to people who are going through the same thing as you on our private Facebook group, Parlons cancer du sein (mainly in French) or if you’re interested, to find out about other parenting options.
References and resources
Kids after cancer: it is possible; Rossy Cancer Network
Cancer du sein et grossesse; CHU de Québec (in French only)
Ressources et soutien en procréation assistée (in French)